Concomitant coronary and renal revascularization improves left ventricular hypertrophy more than coronary stenting alone in patients with ischemic heart and renal disease
Percutaneous transluminal renal artery stenting (PTRAS) has been proved to have no more benefit than medication alone in treating atherosclerotic renal artery stenosis (ARAS). Whether PTRAS could improve left ventricular hypertrophy (LVH) and reduce adverse events when based on percutaneous coronary...
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description | Percutaneous transluminal renal artery stenting (PTRAS) has been proved to have no more benefit than medication alone in treating atherosclerotic renal artery stenosis (ARAS). Whether PTRAS could improve left ventricular hypertrophy (LVH) and reduce adverse events when based on percutaneous coronary intervention (PCI) for patients with coronary artery disease (CAD) and ARAS is still unclear. A retrospective study was conducted, which explored the effect of concomitant PCI and PTRAS versus PCI alone for patients with CAD and ARAS complicated by heart failure with preserved ejection fraction (HFpEF). A total of 228 patients meeting inclusion criteria were divided into two groups: (1) the HFpEF-I group, with PCI and PTRAS; (2) the HFpEF-II group, with PCI alone. Both groups had a two-year follow-up. The left ventricular mass index (LVMI) and other clinical characteristics were compared between groups. During the follow-up period, a substantial decrease in systolic blood pressure (SBP) was observed in the HFpEF-I group, but not in the HFpEF-II group. There was marked decrease in LVMI in both groups, but the HFpEF-I group showed a greater decrease than the HFpEF-II group. Regression analysis demonstrated that PTRAS was significantly associated with LVMI reduction and fewer adverse events after adjusting for other factors. In HFpEF patients with both CAD and ARAS, concomitant PCI and PTRAS can improve LVH and decrease the incidence of adverse events more than PCI alone. This study highlights the beneficial effect of ARAS revascularization, as a new and more aggressive revascularization strategy for such high-risk patients. |
doi_str_mv | 10.1631/jzus.B1500071 |
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Whether PTRAS could improve left ventricular hypertrophy (LVH) and reduce adverse events when based on percutaneous coronary intervention (PCI) for patients with coronary artery disease (CAD) and ARAS is still unclear. A retrospective study was conducted, which explored the effect of concomitant PCI and PTRAS versus PCI alone for patients with CAD and ARAS complicated by heart failure with preserved ejection fraction (HFpEF). A total of 228 patients meeting inclusion criteria were divided into two groups: (1) the HFpEF-I group, with PCI and PTRAS; (2) the HFpEF-II group, with PCI alone. Both groups had a two-year follow-up. The left ventricular mass index (LVMI) and other clinical characteristics were compared between groups. During the follow-up period, a substantial decrease in systolic blood pressure (SBP) was observed in the HFpEF-I group, but not in the HFpEF-II group. There was marked decrease in LVMI in both groups, but the HFpEF-I group showed a greater decrease than the HFpEF-II group. Regression analysis demonstrated that PTRAS was significantly associated with LVMI reduction and fewer adverse events after adjusting for other factors. In HFpEF patients with both CAD and ARAS, concomitant PCI and PTRAS can improve LVH and decrease the incidence of adverse events more than PCI alone. This study highlights the beneficial effect of ARAS revascularization, as a new and more aggressive revascularization strategy for such high-risk patients.</description><identifier>ISSN: 1673-1581</identifier><identifier>EISSN: 1862-1783</identifier><identifier>DOI: 10.1631/jzus.B1500071</identifier><identifier>PMID: 26739528</identifier><language>eng</language><publisher>Hangzhou: Zhejiang University Press</publisher><subject>Aged ; Arteriosclerosis ; Atherosclerosis ; Biomedical and Life Sciences ; Biomedicine ; Blood pressure ; Cardio-Renal Syndrome - diagnosis ; Cardio-Renal Syndrome - surgery ; Cardiovascular disease ; Combined Modality Therapy - methods ; Coronary artery ; Coronary artery disease ; Coronary Artery Disease - diagnosis ; Coronary Artery Disease - surgery ; Drugs ; Female ; Heart ; Heart diseases ; Humans ; Hypertrophy ; Hypertrophy, Left Ventricular - diagnosis ; Hypertrophy, Left Ventricular - surgery ; Incidence ; Intervention ; Ischemia ; Kidney diseases ; Kidney transplantation ; Male ; Myocardial Ischemia - diagnosis ; Myocardial Ischemia - surgery ; Patients ; Percutaneous Coronary Intervention - methods ; Regression analysis ; Renal artery ; Renal Artery - surgery ; Renal Artery Obstruction - diagnosis ; Renal Artery Obstruction - surgery ; Retrospective Studies ; Risk groups ; Stenosis ; Stents ; Treatment Outcome ; Ventricle</subject><ispartof>Journal of Zhejiang University. B. Science, 2016, Vol.17 (1), p.67-75</ispartof><rights>Zhejiang University and Springer-Verlag Berlin Heidelberg 2016</rights><rights>Journal of Zhejiang University SCIENCE B is a copyright of Springer, 2016.</rights><rights>Copyright © Zhejiang University and Springer-Verlag Berlin Heidelberg 2016 2016</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c454t-db0eda15715531eaf57fad66b9346f66cc8c96ceb0e743294e142859f3d2a3313</citedby><cites>FETCH-LOGICAL-c454t-db0eda15715531eaf57fad66b9346f66cc8c96ceb0e743294e142859f3d2a3313</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4710842/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4710842/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,727,780,784,885,27924,27925,41488,42557,51319,53791,53793</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26739528$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Dong, Hao-jian</creatorcontrib><creatorcontrib>Huang, Cheng</creatorcontrib><creatorcontrib>Luo, De-mou</creatorcontrib><creatorcontrib>Ye, Jing-guang</creatorcontrib><creatorcontrib>Yang, Jun-qing</creatorcontrib><creatorcontrib>Li, Guang</creatorcontrib><creatorcontrib>Luo, Jian-fang</creatorcontrib><creatorcontrib>Zhou, Ying-ling</creatorcontrib><title>Concomitant coronary and renal revascularization improves left ventricular hypertrophy more than coronary stenting alone in patients with ischemic heart and renal disease</title><title>Journal of Zhejiang University. B. Science</title><addtitle>J. Zhejiang Univ. Sci. B</addtitle><addtitle>J Zhejiang Univ Sci B</addtitle><description>Percutaneous transluminal renal artery stenting (PTRAS) has been proved to have no more benefit than medication alone in treating atherosclerotic renal artery stenosis (ARAS). Whether PTRAS could improve left ventricular hypertrophy (LVH) and reduce adverse events when based on percutaneous coronary intervention (PCI) for patients with coronary artery disease (CAD) and ARAS is still unclear. A retrospective study was conducted, which explored the effect of concomitant PCI and PTRAS versus PCI alone for patients with CAD and ARAS complicated by heart failure with preserved ejection fraction (HFpEF). A total of 228 patients meeting inclusion criteria were divided into two groups: (1) the HFpEF-I group, with PCI and PTRAS; (2) the HFpEF-II group, with PCI alone. Both groups had a two-year follow-up. The left ventricular mass index (LVMI) and other clinical characteristics were compared between groups. During the follow-up period, a substantial decrease in systolic blood pressure (SBP) was observed in the HFpEF-I group, but not in the HFpEF-II group. There was marked decrease in LVMI in both groups, but the HFpEF-I group showed a greater decrease than the HFpEF-II group. Regression analysis demonstrated that PTRAS was significantly associated with LVMI reduction and fewer adverse events after adjusting for other factors. In HFpEF patients with both CAD and ARAS, concomitant PCI and PTRAS can improve LVH and decrease the incidence of adverse events more than PCI alone. This study highlights the beneficial effect of ARAS revascularization, as a new and more aggressive revascularization strategy for such high-risk patients.</description><subject>Aged</subject><subject>Arteriosclerosis</subject><subject>Atherosclerosis</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Blood pressure</subject><subject>Cardio-Renal Syndrome - diagnosis</subject><subject>Cardio-Renal Syndrome - surgery</subject><subject>Cardiovascular disease</subject><subject>Combined Modality Therapy - methods</subject><subject>Coronary artery</subject><subject>Coronary artery disease</subject><subject>Coronary Artery Disease - diagnosis</subject><subject>Coronary Artery Disease - surgery</subject><subject>Drugs</subject><subject>Female</subject><subject>Heart</subject><subject>Heart diseases</subject><subject>Humans</subject><subject>Hypertrophy</subject><subject>Hypertrophy, Left Ventricular - diagnosis</subject><subject>Hypertrophy, Left Ventricular - surgery</subject><subject>Incidence</subject><subject>Intervention</subject><subject>Ischemia</subject><subject>Kidney diseases</subject><subject>Kidney transplantation</subject><subject>Male</subject><subject>Myocardial Ischemia - diagnosis</subject><subject>Myocardial Ischemia - surgery</subject><subject>Patients</subject><subject>Percutaneous Coronary Intervention - methods</subject><subject>Regression analysis</subject><subject>Renal artery</subject><subject>Renal Artery - surgery</subject><subject>Renal Artery Obstruction - diagnosis</subject><subject>Renal Artery Obstruction - surgery</subject><subject>Retrospective Studies</subject><subject>Risk groups</subject><subject>Stenosis</subject><subject>Stents</subject><subject>Treatment Outcome</subject><subject>Ventricle</subject><issn>1673-1581</issn><issn>1862-1783</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNptkk-P1CAYxhujcdfVo1dD4sVLR95Cob2Y6MR_ySZe9EwY-nbKpIUKdMzsR_JTyji762i8AOH55eF9wlMUz4GuQDB4vbtZ4uod1JRSCQ-KS2hEVYJs2MN8FpKVUDdwUTyJcUcp51SKx8VFlYW2rprL4ufaO-Mnm7RLxPjgnQ4Hol1HAjo95nWvo1lGHeyNTtY7Yqc5-D1GMmKfyB5dCvY3QIbDjCEFPw8HMvmAJA3a_TGNKbPWbYkevUNiHZmzY76L5IdNA7HRDDhZQwbUIZ3N0NmIOuLT4lGvx4jPbver4tuH91_Xn8rrLx8_r99el4bXPJXdhmKnoZZQ1wxQ97XsdSfEpmVc9EIY05hWGMyY5KxqOQKvmrrtWVdpxoBdFW9OvvOymbAzx4R6VHOwU46hvLbqb8XZQW39XnEJtOFVNnh1axD89wVjUlPOhuOoHfolKpCCNg0HyTL68h9055eQQ2eqBdYIKYFnqjxRJvgYA_b3wwBVxxaoYwvUXQsy_-I8wT199-0ZWJ2AmCW3xXD27H8dfwGtcsQD</recordid><startdate>2016</startdate><enddate>2016</enddate><creator>Dong, Hao-jian</creator><creator>Huang, Cheng</creator><creator>Luo, De-mou</creator><creator>Ye, Jing-guang</creator><creator>Yang, Jun-qing</creator><creator>Li, Guang</creator><creator>Luo, Jian-fang</creator><creator>Zhou, Ying-ling</creator><general>Zhejiang University Press</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7QP</scope><scope>7TK</scope><scope>7X2</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABJCF</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>ATCPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>BKSAR</scope><scope>CCPQU</scope><scope>D1I</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB.</scope><scope>L6V</scope><scope>LK8</scope><scope>M0K</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>M7S</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PATMY</scope><scope>PCBAR</scope><scope>PDBOC</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PTHSS</scope><scope>PYCSY</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>2016</creationdate><title>Concomitant coronary and renal revascularization improves left ventricular hypertrophy more than coronary stenting alone in patients with ischemic heart and renal disease</title><author>Dong, Hao-jian ; Huang, Cheng ; Luo, De-mou ; Ye, Jing-guang ; Yang, Jun-qing ; Li, Guang ; Luo, Jian-fang ; Zhou, Ying-ling</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c454t-db0eda15715531eaf57fad66b9346f66cc8c96ceb0e743294e142859f3d2a3313</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Aged</topic><topic>Arteriosclerosis</topic><topic>Atherosclerosis</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Blood pressure</topic><topic>Cardio-Renal Syndrome - diagnosis</topic><topic>Cardio-Renal Syndrome - surgery</topic><topic>Cardiovascular disease</topic><topic>Combined Modality Therapy - methods</topic><topic>Coronary artery</topic><topic>Coronary artery disease</topic><topic>Coronary Artery Disease - diagnosis</topic><topic>Coronary Artery Disease - surgery</topic><topic>Drugs</topic><topic>Female</topic><topic>Heart</topic><topic>Heart diseases</topic><topic>Humans</topic><topic>Hypertrophy</topic><topic>Hypertrophy, Left Ventricular - diagnosis</topic><topic>Hypertrophy, Left Ventricular - surgery</topic><topic>Incidence</topic><topic>Intervention</topic><topic>Ischemia</topic><topic>Kidney diseases</topic><topic>Kidney transplantation</topic><topic>Male</topic><topic>Myocardial Ischemia - diagnosis</topic><topic>Myocardial Ischemia - surgery</topic><topic>Patients</topic><topic>Percutaneous Coronary Intervention - methods</topic><topic>Regression analysis</topic><topic>Renal artery</topic><topic>Renal Artery - surgery</topic><topic>Renal Artery Obstruction - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Journal of Zhejiang University. B. Science</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Dong, Hao-jian</au><au>Huang, Cheng</au><au>Luo, De-mou</au><au>Ye, Jing-guang</au><au>Yang, Jun-qing</au><au>Li, Guang</au><au>Luo, Jian-fang</au><au>Zhou, Ying-ling</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Concomitant coronary and renal revascularization improves left ventricular hypertrophy more than coronary stenting alone in patients with ischemic heart and renal disease</atitle><jtitle>Journal of Zhejiang University. B. Science</jtitle><stitle>J. Zhejiang Univ. Sci. B</stitle><addtitle>J Zhejiang Univ Sci B</addtitle><date>2016</date><risdate>2016</risdate><volume>17</volume><issue>1</issue><spage>67</spage><epage>75</epage><pages>67-75</pages><issn>1673-1581</issn><eissn>1862-1783</eissn><abstract>Percutaneous transluminal renal artery stenting (PTRAS) has been proved to have no more benefit than medication alone in treating atherosclerotic renal artery stenosis (ARAS). Whether PTRAS could improve left ventricular hypertrophy (LVH) and reduce adverse events when based on percutaneous coronary intervention (PCI) for patients with coronary artery disease (CAD) and ARAS is still unclear. A retrospective study was conducted, which explored the effect of concomitant PCI and PTRAS versus PCI alone for patients with CAD and ARAS complicated by heart failure with preserved ejection fraction (HFpEF). A total of 228 patients meeting inclusion criteria were divided into two groups: (1) the HFpEF-I group, with PCI and PTRAS; (2) the HFpEF-II group, with PCI alone. Both groups had a two-year follow-up. The left ventricular mass index (LVMI) and other clinical characteristics were compared between groups. During the follow-up period, a substantial decrease in systolic blood pressure (SBP) was observed in the HFpEF-I group, but not in the HFpEF-II group. There was marked decrease in LVMI in both groups, but the HFpEF-I group showed a greater decrease than the HFpEF-II group. Regression analysis demonstrated that PTRAS was significantly associated with LVMI reduction and fewer adverse events after adjusting for other factors. In HFpEF patients with both CAD and ARAS, concomitant PCI and PTRAS can improve LVH and decrease the incidence of adverse events more than PCI alone. This study highlights the beneficial effect of ARAS revascularization, as a new and more aggressive revascularization strategy for such high-risk patients.</abstract><cop>Hangzhou</cop><pub>Zhejiang University Press</pub><pmid>26739528</pmid><doi>10.1631/jzus.B1500071</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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subjects | Aged Arteriosclerosis Atherosclerosis Biomedical and Life Sciences Biomedicine Blood pressure Cardio-Renal Syndrome - diagnosis Cardio-Renal Syndrome - surgery Cardiovascular disease Combined Modality Therapy - methods Coronary artery Coronary artery disease Coronary Artery Disease - diagnosis Coronary Artery Disease - surgery Drugs Female Heart Heart diseases Humans Hypertrophy Hypertrophy, Left Ventricular - diagnosis Hypertrophy, Left Ventricular - surgery Incidence Intervention Ischemia Kidney diseases Kidney transplantation Male Myocardial Ischemia - diagnosis Myocardial Ischemia - surgery Patients Percutaneous Coronary Intervention - methods Regression analysis Renal artery Renal Artery - surgery Renal Artery Obstruction - diagnosis Renal Artery Obstruction - surgery Retrospective Studies Risk groups Stenosis Stents Treatment Outcome Ventricle |
title | Concomitant coronary and renal revascularization improves left ventricular hypertrophy more than coronary stenting alone in patients with ischemic heart and renal disease |
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