Renal artery stenosis and left ventricular hypertrophy: An updated review and meta-analysis of echocardiographic studies

Cesare Cuspidi, Raffaella Dell'Oro, Carla Sala, Marijana Tadic, Elisa Gherbesi, Guido Grassi, Giuseppe Mancia

Research output: Contribution to journalReview article

Abstract

Aim: Data on left ventricular hypertrophy (LVH) in patients with renal artery stenosis (RAS) and its regression following renal revascularization are scanty. We performed a meta-analysis to provide comprehensive information on this clinically relevant issue. Methods: Full articles providing data on: LVH, as assessed by echocardiography, in RAS patients as compared with essential hypertensive counterparts; changes of left ventricular (LV) mass index after renal artery revascularization were considered. Results: A total of 905 study participants (RAS=446, essential hypertensive=459) of both sex were included in nine studies. Pooled LV mass index was higher in RAS than in essential hypertensive patients (140.4±11.1g/m 2 versus 121.8±6.2g/m 2, standard mean difference being 0.41±0.07 [95% confidence interval (CI) 0.27-0.51, P<0.001]. Among 360 RAS patients undergone renal revascularization from eight studies, baseline and post-intervention pooled mean LV mass index values were 129.0±10.2g/m 2 and 115.5±9.9g/m 2, respectively, the standard mean difference being-0.36±0.06 (95% CI from -0.47 to -0.25, P<0.001). These findings were unaffected by publication bias or single study effect. Conclusion: Our meta-analysis indicates that RAS patients have an increased likelihood of LVH compared with essential hypertensive counterparts and renal artery revascularization has a beneficial effect on LV structure, as reflected by a significant decrease in LV mass index.

Original languageEnglish
Pages (from-to)2339-2345
Number of pages7
JournalJournal of Hypertension
Volume35
Issue number12
DOIs
Publication statusPublished - Dec 1 2017

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Renal Artery Obstruction
Left Ventricular Hypertrophy
Meta-Analysis
Renal Artery
Confidence Intervals
Kidney
Publication Bias
Echocardiography

Keywords

  • hypertension
  • left ventricular hypertrophy
  • renal artery stenosis

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Renal artery stenosis and left ventricular hypertrophy : An updated review and meta-analysis of echocardiographic studies. / Cuspidi, Cesare; Dell'Oro, Raffaella; Sala, Carla; Tadic, Marijana; Gherbesi, Elisa; Grassi, Guido; Mancia, Giuseppe.

In: Journal of Hypertension, Vol. 35, No. 12, 01.12.2017, p. 2339-2345.

Research output: Contribution to journalReview article

Cuspidi, Cesare ; Dell'Oro, Raffaella ; Sala, Carla ; Tadic, Marijana ; Gherbesi, Elisa ; Grassi, Guido ; Mancia, Giuseppe. / Renal artery stenosis and left ventricular hypertrophy : An updated review and meta-analysis of echocardiographic studies. In: Journal of Hypertension. 2017 ; Vol. 35, No. 12. pp. 2339-2345.
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abstract = "Aim: Data on left ventricular hypertrophy (LVH) in patients with renal artery stenosis (RAS) and its regression following renal revascularization are scanty. We performed a meta-analysis to provide comprehensive information on this clinically relevant issue. Methods: Full articles providing data on: LVH, as assessed by echocardiography, in RAS patients as compared with essential hypertensive counterparts; changes of left ventricular (LV) mass index after renal artery revascularization were considered. Results: A total of 905 study participants (RAS=446, essential hypertensive=459) of both sex were included in nine studies. Pooled LV mass index was higher in RAS than in essential hypertensive patients (140.4±11.1g/m 2 versus 121.8±6.2g/m 2, standard mean difference being 0.41±0.07 [95{\%} confidence interval (CI) 0.27-0.51, P<0.001]. Among 360 RAS patients undergone renal revascularization from eight studies, baseline and post-intervention pooled mean LV mass index values were 129.0±10.2g/m 2 and 115.5±9.9g/m 2, respectively, the standard mean difference being-0.36±0.06 (95{\%} CI from -0.47 to -0.25, P<0.001). These findings were unaffected by publication bias or single study effect. Conclusion: Our meta-analysis indicates that RAS patients have an increased likelihood of LVH compared with essential hypertensive counterparts and renal artery revascularization has a beneficial effect on LV structure, as reflected by a significant decrease in LV mass index.",
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T2 - An updated review and meta-analysis of echocardiographic studies

AU - Cuspidi, Cesare

AU - Dell'Oro, Raffaella

AU - Sala, Carla

AU - Tadic, Marijana

AU - Gherbesi, Elisa

AU - Grassi, Guido

AU - Mancia, Giuseppe

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N2 - Aim: Data on left ventricular hypertrophy (LVH) in patients with renal artery stenosis (RAS) and its regression following renal revascularization are scanty. We performed a meta-analysis to provide comprehensive information on this clinically relevant issue. Methods: Full articles providing data on: LVH, as assessed by echocardiography, in RAS patients as compared with essential hypertensive counterparts; changes of left ventricular (LV) mass index after renal artery revascularization were considered. Results: A total of 905 study participants (RAS=446, essential hypertensive=459) of both sex were included in nine studies. Pooled LV mass index was higher in RAS than in essential hypertensive patients (140.4±11.1g/m 2 versus 121.8±6.2g/m 2, standard mean difference being 0.41±0.07 [95% confidence interval (CI) 0.27-0.51, P<0.001]. Among 360 RAS patients undergone renal revascularization from eight studies, baseline and post-intervention pooled mean LV mass index values were 129.0±10.2g/m 2 and 115.5±9.9g/m 2, respectively, the standard mean difference being-0.36±0.06 (95% CI from -0.47 to -0.25, P<0.001). These findings were unaffected by publication bias or single study effect. Conclusion: Our meta-analysis indicates that RAS patients have an increased likelihood of LVH compared with essential hypertensive counterparts and renal artery revascularization has a beneficial effect on LV structure, as reflected by a significant decrease in LV mass index.

AB - Aim: Data on left ventricular hypertrophy (LVH) in patients with renal artery stenosis (RAS) and its regression following renal revascularization are scanty. We performed a meta-analysis to provide comprehensive information on this clinically relevant issue. Methods: Full articles providing data on: LVH, as assessed by echocardiography, in RAS patients as compared with essential hypertensive counterparts; changes of left ventricular (LV) mass index after renal artery revascularization were considered. Results: A total of 905 study participants (RAS=446, essential hypertensive=459) of both sex were included in nine studies. Pooled LV mass index was higher in RAS than in essential hypertensive patients (140.4±11.1g/m 2 versus 121.8±6.2g/m 2, standard mean difference being 0.41±0.07 [95% confidence interval (CI) 0.27-0.51, P<0.001]. Among 360 RAS patients undergone renal revascularization from eight studies, baseline and post-intervention pooled mean LV mass index values were 129.0±10.2g/m 2 and 115.5±9.9g/m 2, respectively, the standard mean difference being-0.36±0.06 (95% CI from -0.47 to -0.25, P<0.001). These findings were unaffected by publication bias or single study effect. Conclusion: Our meta-analysis indicates that RAS patients have an increased likelihood of LVH compared with essential hypertensive counterparts and renal artery revascularization has a beneficial effect on LV structure, as reflected by a significant decrease in LV mass index.

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