Superiority of acceleration and acceleration time over pulsatility and resistance indices as screening tests for renal artery stenosis

Larry Burdick, Flavio Airoldi, Ivana Marana, Marco Giussani, Cristina Alberti, Massimo Cianci, Andrea Lovaria, Silvia Saccheri, Gabriella Gazzano, Alberto Morganti

Research output: Contribution to journalArticlepeer-review

Abstract

Objective. To compare the accuracy of four echo-Doppler-derived velocimetric indices (pulsatility and resistance indices, acceleration and acceleration time) in detecting renal artery stenosis in hypertensive patients. Patients and methods. In 73 hospitalized patients with moderate-to-severe hypertension, 18 of whom had normal renal arteries and 55 renal artery stenosis (50-95%) either atherosclerotic (30 cases, five bilateral) or fibromuscular dysplasia (25 cases, two bilateral), we measured the four velocimetric indices using the lateral abdominal approach and sampling Doppler waveforms distally to the stenosis. The diagnostic accuracy of each index was calculated using as cut-off limit the ideal threshold determined with the receiver-operating characteristic curves. Results. On average all of the indices were altered significantly in arteries with stenosis of both aetiologies with respect to normal arteries, the alterations of pulsatility and resistance indices being, however, less pronounced than those of acceleration and acceleration time, particularly in atherosclerotic stenosis. With the cut-off limits of 0.93, 0.59 and 7.4 m/s 2 and 60 ms, respectively, for pulsatility and resistance indices, acceleration and acceleration time, their diagnostic accuracies were 80, 73, 93 and 92%. In stenotic arteries, only the acceleration time was correlated with the degree of arterial narrowing, whereas, in normal arteries, only pulsatility and resistance indices were directly correlated with the age of patients. Conclusions. Acceleration and acceleration time are more accurate indices than pulsatility and resistance to screen for renal artery stenosis, probably because their alterations are less attenuated by the counterbalancing effects of age and of atherosclerosis.

Original languageEnglish
Pages (from-to)1229-1235
Number of pages7
JournalJournal of Hypertension
Volume14
Issue number10
DOIs
Publication statusPublished - 1996

Keywords

  • Age
  • Atherosclerosis
  • Echo-Doppler velocimetry
  • Renal artery stenosis

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology

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