TY - JOUR
T1 - Frequency of severe renal artery stenosis in patients with severe thoracic aortic plaque
AU - Reynolds, Harmony R.
AU - Tunick, Paul A.
AU - Benenstein, Ricardo J.
AU - Nakra, Navin C.
AU - Shah, Alan
AU - Spevack, Daniel M.
AU - Kronzon, Itzhak
PY - 2004/9/15
Y1 - 2004/9/15
N2 - Atherosclerotic renal artery stenosis (RAS) is an underdiagnosed disorder and a treatable etiology of hypertension and renal insufficiency. All patients were referred for a transesophageal echocardiogram for various indications. Abdominal ultrasound was performed in 69 patients, 43 with severe thoracic aortic plaque (≥4 mm) and 26 controls with no or mild plaque (≤2 mm). Severe RAS (≥60%) was defined as flow velocity ≥1.8 m/s and a renal:aortic ratio of ≥3.5. There were 8 cases of RAS (all severe) in the 43 patients with severe aortic plaque (19% vs 0% of controls; p = 0.02). Severe plaque (p = 0.02) and hypertension (p = 0.03) were correlated with RAS. On multivariate analysis, severe plaque (p = 0.017) and hypertension (p = 0.002) remained independently correlated with RAS. In a paired analysis, matched for age and gender (McNemar), severe plaque was significantly associated with RAS (p = 0.008). Severe thoracic aortic plaque is strongly associated with RAS, which is found in 19% of patients with severe plaque. Patients found to have severe aortic plaque on transesophageal echocardiography should be screened for RAS.
AB - Atherosclerotic renal artery stenosis (RAS) is an underdiagnosed disorder and a treatable etiology of hypertension and renal insufficiency. All patients were referred for a transesophageal echocardiogram for various indications. Abdominal ultrasound was performed in 69 patients, 43 with severe thoracic aortic plaque (≥4 mm) and 26 controls with no or mild plaque (≤2 mm). Severe RAS (≥60%) was defined as flow velocity ≥1.8 m/s and a renal:aortic ratio of ≥3.5. There were 8 cases of RAS (all severe) in the 43 patients with severe aortic plaque (19% vs 0% of controls; p = 0.02). Severe plaque (p = 0.02) and hypertension (p = 0.03) were correlated with RAS. On multivariate analysis, severe plaque (p = 0.017) and hypertension (p = 0.002) remained independently correlated with RAS. In a paired analysis, matched for age and gender (McNemar), severe plaque was significantly associated with RAS (p = 0.008). Severe thoracic aortic plaque is strongly associated with RAS, which is found in 19% of patients with severe plaque. Patients found to have severe aortic plaque on transesophageal echocardiography should be screened for RAS.
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U2 - 10.1016/j.amjcard.2004.05.077
DO - 10.1016/j.amjcard.2004.05.077
M3 - Article
C2 - 15374808
AN - SCOPUS:4544366745
SN - 0002-9149
VL - 94
SP - 844
EP - 846
JO - American Journal of Cardiology
JF - American Journal of Cardiology
IS - 6
ER -