PMID- 23913461 OWN - NLM STAT- MEDLINE DCOM- 20140811 LR - 20220410 IS - 1898-018X (Electronic) IS - 1898-018X (Linking) VI - 20 IP - 4 DP - 2013 TI - Prognostic value of renal fractional flow reserve in blood pressure response after renal artery stenting (PREFER study). PG - 418-22 LID - 10.5603/CJ.2013.0101 [doi] AB - BACKGROUND: The aim of our study was to determine a potential relationship between resting translesional pressures ratio (Pd/Pa ratio), renal fractional flow reserve (rFFR) and blood pressure response after renal artery stenting. METHODS: Thirty five hypertensive patients (49% males, mean age 64 years) with at least 60% stenosis in angiography, underwent renal artery stenting. Translesional systolic pressure gradient (TSPG), Pd/Pa ratio (the ratio of mean distal to lesion and mean proximal pressures) and hyperemic rFFR - after intrarenal administration of papaverine - were measured before stent implantation. Ambulatory blood pressure measurements (ABPM) were recorded before the procedure and after 6 months. The ABPM results were presented as blood pressure changes in subgroups of patients with normal (>/= 0.9) vs. abnormal (< 0.9) Pd/Pa ratio and normal (>/= 0.8) vs. abnormal (< 0.8) rFFR. RESULTS: Median Pd/Pa ratio was 0.84 (interquartile range 0.79-0.91) and strongly correlated with TSPG (r = -0.89, p < 0.001), minimal lumen diameter (MLD; r = 0.53, p < 0.005) and diameter stenosis (DS; r = -0.51, p < 0.005). Median rFFR was 0.78 (0.72-0.82). Similarly, significant correlation between rFFR and TSPG (r = -0.86, p < 0.0001), as well as with MLD (r = 0.50, p < 0.005) and DS (r = -0.51, p < 0.005) was observed. Procedural success was obtained in all patients. Baseline Pd/Pa ratio and rFFR did not predict hypertension response after renal artery stenting. Median changes of 24-h systolic/diastolic blood pressure were comparable in patients with abnormal vs. normal Pd/Pa ratio (-4/-3 vs. 0/2 mm Hg; p = NS) and with abnormal vs. normal rFFR (-2/-1 vs. -2/-0.5 mm Hg, respectively). CONCLUSIONS: Physiological assessment of renal artery stenosis using Pd/Pa ratio and papaverine- induced renal fractional fl ow reserve did not predict hypertension response after renal artery stenting. FAU - Kadziela, Jacek AU - Kadziela J AD - Institute of Cardiology, Warsaw, Poland. kadziela@ikard.pl. FAU - Januszewicz, Andrzej AU - Januszewicz A FAU - Prejbisz, Aleksander AU - Prejbisz A FAU - Michalowska, Ilona AU - Michalowska I FAU - Januszewicz, Magdalena AU - Januszewicz M FAU - Florczak, Elzbieta AU - Florczak E FAU - Kalinczuk, Lukasz AU - Kalinczuk L FAU - Norwa-Otto, Bozena AU - Norwa-Otto B FAU - Warchol, Ewa AU - Warchol E FAU - Witkowski, Adam AU - Witkowski A LA - eng SI - ClinicalTrials.gov/NCT01128933 GR - 2P05B02530/PHS HHS/United States PT - Journal Article PT - Research Support, N.I.H., Extramural PL - Poland TA - Cardiol J JT - Cardiology journal JID - 101392712 RN - 0 (Vasodilator Agents) RN - DAA13NKG2Q (Papaverine) SB - IM CIN - Cardiol J. 2014;21(3):329. PMID: 24961551 CIN - Cardiol J. 2014;21(3):330. PMID: 24961552 MH - Aged MH - Angioplasty/*instrumentation MH - *Blood Pressure MH - Blood Pressure Monitoring, Ambulatory MH - Female MH - Humans MH - Hypertension, Renovascular/diagnosis/physiopathology/*therapy MH - Male MH - Middle Aged MH - Multidetector Computed Tomography MH - Papaverine MH - Predictive Value of Tests MH - Renal Artery Obstruction/diagnosis/physiopathology/*therapy MH - *Renal Circulation MH - *Stents MH - Time Factors MH - Treatment Outcome MH - Ultrasonography, Doppler, Duplex MH - Vasodilator Agents EDAT- 2013/08/06 06:00 MHDA- 2014/08/12 06:00 CRDT- 2013/08/06 06:00 PHST- 2013/07/26 00:00 [received] PHST- 2013/07/26 00:00 [accepted] PHST- 2013/08/06 06:00 [entrez] PHST- 2013/08/06 06:00 [pubmed] PHST- 2014/08/12 06:00 [medline] AID - VM/OJS/J/35302 [pii] AID - 10.5603/CJ.2013.0101 [doi] PST - ppublish SO - Cardiol J. 2013;20(4):418-22. doi: 10.5603/CJ.2013.0101.