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首页> 外文期刊>Polish Archives of Internal Medicine >Effects of short- and long?term efficacy of percutaneous transluminal renal angioplasty with or without intravascular brachytherapy on regression of left ventricular hypertrophy in patients with renovascular hypertension
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Effects of short- and long?term efficacy of percutaneous transluminal renal angioplasty with or without intravascular brachytherapy on regression of left ventricular hypertrophy in patients with renovascular hypertension

机译：经皮腔内肾成形术联合或不联合血管内近距离放射治疗短期和长期疗效对肾性高血压患者左室肥厚消退的影响

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Introduction The largest group of patients with secondary hypertension comprises individuals with renovascular hypertension resulting from renal artery stenosis that is a potentially removable condition. It is caused by atherosclerosis in 70–80% of patients. Objectives The aim of the study was to evaluate the influence of intravascular brachytherapy (IVBT) procedure performed after percutaneous transluminal renal angioplasty (PTRA) on left ventricular (LV) function, mass regression and type of hypertrophy (LVH) determined on echocardiography during long?term follow?up. Patients and methods Sixty?two patients with atherosclerotic renal artery stenosis complicated by severe hypertension were treated with PTRA and randomly assigned to group 1 (PTRA alone) or group 2 (PTRA followed by IVBT). Subsequent IVBT was performed with the PARIS? catheter and the Microselectron HDR (Nucletron?) system for peripheral arteries. Treatment outcomes during follow?up were assessed with quantitative coronary angiography. LV mass and mass index (LVM and LVMI) and functional parameters prior to PTRA and during follow?up were determined by echocardiography with regard to the type of procedure. Results The degree of renal artery stenosis was significantly different in groups 1 and 2. In both groups elevated LVMI was observed (p = 0.94). There were no significant differences in interventricular septum (IVS) to LV posterior wall (LVPW) ratio, relative LV wall thickness, volumetric parameters and LV ejection fraction between both groups. During follow?up the values of LVMI and IVS to LVPW ratio were significantly lower (p = 0.021 and p = 0.004, respectively) in the PTRA + IVBT group compared to the PTRA group. Analysis of the LV geometry and type of hypertrophy revealed a marked reduction in concentric LVH in the IVBT group during long-term follow?up. Conclusions Echocardiographic evaluation comparing several LV parameters in the PTRA alone and PTRA + IVBT groups showed that PTRA with subsequent brachytherapy were associated with better control of blood pressure and greater LVM regression, especially concentric hypertrophy, during long?term follow?up.
机译：引言最大的继发性高血压患者包括肾动脉狭窄引起的肾血管性高血压，这是一种潜在的可移动性疾病。它是由70–80％的患者的动脉粥样硬化引起的。目的本研究的目的是评估经皮腔内肾成形术（PTRA）后进行血管内近距离放疗（IVBT）程序对长期超声心动图确定的左心室（LV）功能，质量消退和肥大类型（LVH）的影响。学期随访？患者和方法对62例伴有严重高血压的动脉粥样硬化性肾动脉狭窄患者进行PTRA治疗，并随机分为第1组（仅PTRA）或第2组（PTRA，然后进行IVBT）。随后的IVBT与PARIS一起进行？导管和用于外周动脉的Microselectron HDR（Nucletron？）系统。随访期间的治疗结果通过定量冠状动脉造影评估。通过超声心动图确定术式，确定PTRA之前和随访期间的LV质量和质量指数（LVM和LVMI）和功能参数。结果在第1组和第2组中，肾动脉狭窄程度显着不同。在两组中均观察到LVMI升高（p = 0.94）。两组之间的室间隔（IVS）与LV后壁（LVPW）的比率，相对LV壁厚，体积参数和LV射血分数均无显着差异。在随访期间，与PTRA组相比，PTRA + IVBT组的LVMI和IVS与LVPW的比值显着降低（分别为p = 0.021和p = 0.004）。对LV几何形状和肥大类型的分析显示，在长期随访中，IVBT组的同心LVH明显减少。结论超声心动图评估比较了单独PTRA组和PTRA + IVBT组的几个LV参数，发现PTRA与随后的近距离放疗在长期随访中与更好的血压控制和更大的LVM消退尤其是同心肥大有关。

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