Vol 71, No 2 (2013)
Original articles
Published online: 2013-02-19
Impact of renal artery stenting on cytokine levels, left ventricle mass and diastolic function
DOI: 10.5603/KP.2013.0003
Kardiol Pol 2013;71(2):121-128.
Abstract
Background: Significant renal artery stenosis (RAS) may lead to left ventricle (LV) hypertrophy and diastolic function (DF) impairment
through complex mechanisms: activation of cytokines and/or systolic and diastolic blood pressure (SBP, DBP) increase.
Aim: To assess interrelations between LV mass (LVM), DF and cytokines in patients undergoing renal artery stenting (PTA,
percutaneous angioplasty of renal artery).
Methods: The study group comprised 72 subjects (44.4% men), 64.1 ± 9.9 years with RAS referred to PTA. SBP, DBP, transforming
growth factor beta1 (TGF-β1), aldosterone, B-type natriuretic peptide (BNP) levels and change in LVM and LVM index
(LVMI) and DF (Evel, e’vel, E/A ratio, E/e’ ratio, Artime-Atime) on echocardiography were assessed preprocedurally, and three and
12 months postprocedurally.
Results: TGF-β1 level decreased from 13.3 ± 14.9 to 8.6 ± 8.0 ng/mL (p = 0.027), while BNP increased from 89.1 ± 86.3 to
131 ± 105 pmol/mL (p < 0.001). A significant reduction in LVMI in women (79.4 ± 16.9 vs. 95.7 ± 18.5 g/m2, p < 0.001)
and men (77.2 ± 16.8 vs. 100.1 ± 19.7 g/m2, p < 0.001) was found at 12 months vs. baseline. Degree of LVM reduction
correlated with baseline LVM (p < 0.001; r = –0.612) and e’vel (p = 0.05; r = 0.230), but not with BP values. Among DF
parameters, only e’vel increased significantly at 12 months (5.54 ± 1.57 vs. 5.92 ± 1.65 cm/s; p = 0.039), while A/E and E/e’
ratio, Artime-Atime remained similar (p = 0.457, p = 0.283 and p = 0.258). Factors associated with e’vel increase ≥ 0.3 cm/s at
12 months were baseline LVM < 165 g (p = 0.043, RR = 1.39, CI 1.01–1.46), Evel (p = 0.015, RR = 1.26, CI 1.15–1.52), e’vel
(p < 0.001, RR = 1.42, CI 1.18–1.7), DBP decrease > 10 mm Hg (p = 0.055, RR = 1.2, CI 1.0–1.44) and TGF-β1 > 8 ng/mL
(p = 0.024, RR = 1.24, CI 1.03–1.49) at 12 months.
Conclusions. Significant LVMI reduction was observed after PTA of RAS, but it was independent of BP reduction. e’vel increase
was independently associated with baseline LVM, Evel, e’vel, and 12 month decrease in DBP > 10 mm Hg.
through complex mechanisms: activation of cytokines and/or systolic and diastolic blood pressure (SBP, DBP) increase.
Aim: To assess interrelations between LV mass (LVM), DF and cytokines in patients undergoing renal artery stenting (PTA,
percutaneous angioplasty of renal artery).
Methods: The study group comprised 72 subjects (44.4% men), 64.1 ± 9.9 years with RAS referred to PTA. SBP, DBP, transforming
growth factor beta1 (TGF-β1), aldosterone, B-type natriuretic peptide (BNP) levels and change in LVM and LVM index
(LVMI) and DF (Evel, e’vel, E/A ratio, E/e’ ratio, Artime-Atime) on echocardiography were assessed preprocedurally, and three and
12 months postprocedurally.
Results: TGF-β1 level decreased from 13.3 ± 14.9 to 8.6 ± 8.0 ng/mL (p = 0.027), while BNP increased from 89.1 ± 86.3 to
131 ± 105 pmol/mL (p < 0.001). A significant reduction in LVMI in women (79.4 ± 16.9 vs. 95.7 ± 18.5 g/m2, p < 0.001)
and men (77.2 ± 16.8 vs. 100.1 ± 19.7 g/m2, p < 0.001) was found at 12 months vs. baseline. Degree of LVM reduction
correlated with baseline LVM (p < 0.001; r = –0.612) and e’vel (p = 0.05; r = 0.230), but not with BP values. Among DF
parameters, only e’vel increased significantly at 12 months (5.54 ± 1.57 vs. 5.92 ± 1.65 cm/s; p = 0.039), while A/E and E/e’
ratio, Artime-Atime remained similar (p = 0.457, p = 0.283 and p = 0.258). Factors associated with e’vel increase ≥ 0.3 cm/s at
12 months were baseline LVM < 165 g (p = 0.043, RR = 1.39, CI 1.01–1.46), Evel (p = 0.015, RR = 1.26, CI 1.15–1.52), e’vel
(p < 0.001, RR = 1.42, CI 1.18–1.7), DBP decrease > 10 mm Hg (p = 0.055, RR = 1.2, CI 1.0–1.44) and TGF-β1 > 8 ng/mL
(p = 0.024, RR = 1.24, CI 1.03–1.49) at 12 months.
Conclusions. Significant LVMI reduction was observed after PTA of RAS, but it was independent of BP reduction. e’vel increase
was independently associated with baseline LVM, Evel, e’vel, and 12 month decrease in DBP > 10 mm Hg.
Keywords: renal artery stenosisrenal artery stentingleft ventricle mass and indexdiastolic functioncytokines
