In:
Journal of Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 39, No. 1 ( 2021-01), p. 4-11
Abstract:
Few echocardiographic studies have focused on regression of left ventricular hypertrophy (LVH) in patients with renal artery stenosis after revascularization, with inconsistent results. We performed a systematic meta-analysis of these studies in order to offer a comprehensive information on this topic. Methods: The PubMed, OVID-MEDLINE, and Cochrane library databases were analyzed to search English-language articles published from 1 January 1990 up to 31 March 2020. Studies were identified by crossing the following terms: ‘renal artery stenosis’, ‘renovascular hypertension’, ‘fibromuscular dysplasia’, ‘renal artery stenting’, ‘renal artery surgery’ with ‘cardiac damage’, ‘hypertensive heart disease’ ‘left ventricular mass’, ‘left ventricular hypertrophy’, ‘echocardiography’. Results: A total of 726 hypertensive patients with renal artery stenosis (mean age 61 years, 64% men, 98% treated, 10% with fibromuscular dysplasia) were included in 13 studies. Baseline and postintervention pooled mean LVM values were 220 ± 15 and 203 ± 19 g, respectively (SMD −0.24 ± 0.06, CI −0.37 to −0.21, P 〈 0.0001); corresponding values for LV mass index were 129.0 ± 6 and 115 ± 7 g/m 2 , respectively (SMD −0.28 ± 0.04, CI −0.36 to 0.21, P 〈 0.0001). Renal revascularization was associated with a 40% lower risk of LVH. This trend was accompanied by a reduction in the number of antihypertensive drugs (SMD −0.27 ± 0.04, CI −0.37 to 0.17, P 〈 0.0001). Conclusion: The present meta-analysis suggests that renal artery revascularization added to antihypertensive therapy promotes a favourable effect on LV structure, as reflected by a significant decrease in absolute and indexed LV mass index as well by a lower risk of LVH. Limitations include: high prevalence of modest renal artery stenosis (≥50%); small sample of fibromuscular dysplasia; lack of randomized design of most studies.
Type of Medium:
Online Resource
ISSN:
0263-6352
,
1473-5598
DOI:
10.1097/HJH.0000000000002586
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2021
detail.hit.zdb_id:
2017684-3
detail.hit.zdb_id:
605532-1
