PMID- 30614643
OWN - NLM
STAT- MEDLINE
DCOM- 20190516
LR  - 20210109
IS  - 2055-5822 (Electronic)
IS  - 2055-5822 (Linking)
VI  - 6
IP  - 2
DP  - 2019 Apr
TI  - Cardiac function response to stenting in atherosclerotic renal artery disease 
      with and without heart failure: results from the Carmel study.
PG  - 319-327
LID - 10.1002/ehf2.12391 [doi]
AB  - AIMS: Consensus-derived guidelines recommend renal stenting for patients with 
      atherosclerotic renal artery disease (ARAD) and heart failure (HF). The aim of 
      this prospective multi-centre observational study was to verify our hypothesis 
      that changes in E/e', an echocardiographic correlate of left ventricular (LV) 
      filling pressure, following renal stenting may differ between ARAD patients with 
      and without HF. METHODS AND RESULTS: This study enrolled de novo ARAD patients 
      undergoing renal stenting at 14 institutions. The primary endpoint was the 
      difference in E/e' change between ARAD patients with and without HF. Clinical and 
      echocardiographic data were prospectively collected at baseline, the day 
      following renal stenting, and 1 month and 6 months afterwards. ARAD patients with 
      HF were defined as patients with New York Heart Association (NYHA) Class 2 and 
      more, or a history of HF hospitalization. A total of 76 patients were included, 
      and 39% were ARAD patients with HF. ARAD patients with HF had significantly lower 
      estimated glomerular filtration rate (P = 0.028) and higher NYHA functional class 
      (P < 0.001) and Minnesota Living with Heart Failure Questionnaire (MLHFQ) score 
      (P = 0.001) than ARAD patients without HF. Also, ARAD patients with HF had 
      significantly lower LV ejection fraction (P = 0.003) and e'-velocity (P = 0.003) 
      and higher E/e' ratio (P = 0.001), left atrial volume index (LAVI) (P = 0.046), 
      LV end-diastolic volume (LVEDV) (P = 0.001), LV end-systolic volume (LVESV) 
      (P = 0.001), and LV mass index (P = 0.009) than ARAD patients without HF. All 
      procedures were successful. In contrast to blood pressure and renal function, 
      there was a significant interaction in E/e' (P(interaction)  < 0.001) between 
      time and HF, and ARAD patients with HF showed a significant (P < 0.001) decrease 
      in E/e' albeit those without HF. By the same token, there was a significant 
      interaction in NYHA class (P(interaction)  < 0.001), MLHFQ score (P(interaction) 
       = 0.018), E-velocity (P(interaction)  = 0.002), LAVI (P(interaction)  = 0.001), 
      LVEDV (P(interaction)  = 0.003), and LVESV (P(interaction)  = 0.001) between time 
      and HF with a significant improvement in all these variables in ARAD patients 
      with HF (NYHA class, P = 0.001; MLHFQ score, P = 0.002; E-velocity, P = 0.005; 
      LAVI, P = 0.001; LVEDV, P = 0.017; and LVESV, P = 0.011). CONCLUSIONS: Change in 
      LV filling pressure after renal stenting differed between ARAD patients with and 
      without HF, with a significant improvement in LV filling pressure in patients 
      with HF-ARAD. These unique findings might support clinical cardiac benefits of 
      renal stenting in ARAD patients with HF.
CI  - (c) 2019 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on 
      behalf of the European Society of Cardiology.
FAU - Kawarada, Osami
AU  - Kawarada O
AD  - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular 
      Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan.
AD  - Department of Cardiovascular Medicine, Ikuwakai Memorial Hospital, Osaka, Japan.
FAU - Kume, Teruyoshi
AU  - Kume T
AD  - Department of Cardiology, Kawasaki Medical School Hospital, Okayama, Japan.
FAU - Zen, Kan
AU  - Zen K
AD  - Department of Cardiovascular Medicine, Kyoto Prefectural University of Medicine, 
      Kyoto, Japan.
FAU - Nakamura, Shigeru
AU  - Nakamura S
AD  - Department of Cardiology, Kyoto Katsura Hospital, Kyoto, Japan.
FAU - Hozawa, Koji
AU  - Hozawa K
AD  - Department of Cardiology, New Tokyo Hospital, Chiba, Japan.
FAU - Akimitsu, Tadafumi
AU  - Akimitsu T
AD  - Department of Cardiology, Oita Cardiovascular Hospital, Oita, Japan.
FAU - Asano, Hiroshi
AU  - Asano H
AD  - Department of Cardiology, Tosei General Hospital, Aichi, Japan.
FAU - Ando, Hiroshi
AU  - Ando H
AD  - Department of Cardiology, Kasukabe Chuo General Hospital, Saitama, Japan.
FAU - Yamamoto, Yoshito
AU  - Yamamoto Y
AD  - Department of Cardiology, Iwaki Kyoritsu Hospital, Fukushima, Japan.
FAU - Yamashita, Takehiro
AU  - Yamashita T
AD  - Department of Cardiology, Hokkaido Ohno Memorial Hospital, Hokkaido, Japan.
FAU - Shinozaki, Norihiko
AU  - Shinozaki N
AD  - Department of Cardiology, Tokai University Hospital, Kanagawa, Japan.
FAU - Odashiro, Keita
AU  - Odashiro K
AD  - Department of Cardiovascular Medicine, Kyushu University Hospital, Fukuoka, 
      Japan.
FAU - Sato, Tadaya
AU  - Sato T
AD  - Department of Cardiology, Saka General Hospital, Miyagi, Japan.
FAU - Yuba, Kenichiro
AU  - Yuba K
AD  - Department of Cardiology, Tokushima Red Cross Hospital, Tokushima, Japan.
FAU - Sakanoue, Yuji
AU  - Sakanoue Y
AD  - Department of Cardiology, Higashisumiyoshi Morimoto Hospital, Osaka, Japan.
FAU - Uzu, Takashi
AU  - Uzu T
AD  - Division of Nephrology, Nippon Life Hospital, Osaka, Japan.
FAU - Okada, Kozo
AU  - Okada K
AD  - Division of Cardiovascular Medicine, Stanford University School of Medicine, 
      Stanford, CA, USA.
FAU - Fitzgerald, Peter J
AU  - Fitzgerald PJ
AD  - Division of Cardiovascular Medicine, Stanford University School of Medicine, 
      Stanford, CA, USA.
FAU - Honda, Yasuhiro
AU  - Honda Y
AD  - Division of Cardiovascular Medicine, Stanford University School of Medicine, 
      Stanford, CA, USA.
FAU - Yasuda, Satoshi
AU  - Yasuda S
AD  - Department of Cardiovascular Medicine, National Cerebral and Cardiovascular 
      Center, 5-7-1 Fujishiro-dai, Suita, Osaka, 565-8565, Japan.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Observational Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20190107
PL  - England
TA  - ESC Heart Fail
JT  - ESC heart failure
JID - 101669191
SB  - IM
MH  - Aged
MH  - Angiography
MH  - Atherosclerosis/complications/diagnosis/*surgery
MH  - *Blood Vessel Prosthesis
MH  - Echocardiography
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/*complications/diagnosis/physiopathology
MH  - Humans
MH  - Japan
MH  - Male
MH  - Prospective Studies
MH  - Renal Artery Obstruction/complications/diagnosis/*surgery
MH  - *Stents
MH  - Stroke Volume/*physiology
MH  - Ultrasonography
MH  - Ventricular Function, Left/*physiology
PMC - PMC6437431
OTO - NOTNLM
OT  - *Failure
OT  - *Heart
OT  - *Kidney
OT  - *Revascularization
OT  - *Stent
COIS- None declared.
EDAT- 2019/01/08 06:00
MHDA- 2019/05/17 06:00
PMCR- 2019/01/07
CRDT- 2019/01/08 06:00
PHST- 2018/06/25 00:00 [received]
PHST- 2018/09/30 00:00 [revised]
PHST- 2018/11/05 00:00 [accepted]
PHST- 2019/01/08 06:00 [pubmed]
PHST- 2019/05/17 06:00 [medline]
PHST- 2019/01/08 06:00 [entrez]
PHST- 2019/01/07 00:00 [pmc-release]
AID - EHF212391 [pii]
AID - 10.1002/ehf2.12391 [doi]
PST - ppublish
SO  - ESC Heart Fail. 2019 Apr;6(2):319-327. doi: 10.1002/ehf2.12391. Epub 2019 Jan 7.