Effect of Renal Artery Stenting on Blood Pressure, Glomerular Filtration Rate and Left Ventricular Mass in Hypertensive Patients with Severe Atherosclerotic Renal Artery Stenosis

Background Many small trials showed a significant improvement in blood pressure following renal artery stenting in patients with severe atherosclerotic renal artery stenosis, but data on renal function improvement is more conflicting. Recently, few trials have been conducted to evaluate the effect of this procedure on Left Ventricular Mass (LVM) and Left Ventricular Mass Index (LVMI). Objectives The aim of this study is to determine the effect of renal artery stenting on Blood Pressure, estimated Glomerular Filtration Rate (eGFR), Left Ventricular Mass (LVM), and Left Ventricular Mass Index (LVMI) in patients with severe atherosclerotic renal artery stenosis. Methods This is a prospective interventional study performed on forty patients with ischemic heart disease and medication resistant hypertension, who had severe (≥ 70%) atherosclerotic renal artery stenosis and underwent renal artery stenting. Blood pressure, LVM, LVMI and eFGR before renal artery stenting and after six months were assessed in these patients. Results There were significant reduction in systolic blood pressure (from 175.50 ± 17.28 mmHg to 137.30 ± 13.21 mmHg) (P < 0.001), and diastolic blood pressure (from 103.45 ± 8.91 mmHg to 84.30 ± 7.33 mmHg) (P < 0.001). Also, there were significant decrease in LVM (from 307.73 ± 108.13 g to 259.34 ± 92.17 g) (P = 0.004) and LVMI (from 174.70 ± 58.26 to 148.01 ± 49.77) (P = 0.004). LVM reduction was independent of SBP and DBP reduction (P = 0.376 and P = 0.196, respectively). Conclusions Renal artery stenting reduces Blood pressure and leads to regression of LVM independent of blood pressure reduction. Regardless of baseline eGFR, our study failed to find a significant increase in glomerular filtration rate

A cross-sectional study of the association between heat shock protein 27 antibody titers, pro-oxidant-antioxidant balance and metabolic syndrome in patients with angiographically-defined coronary artery disease

OBJECTIVE To investigate the association between serum antibody titers to Hsp27 (anti-Hsp27) and pro-oxidant-antioxidant balance (PAB) in patients with angiographically-defined coronary artery disease (CAD) with or without the metabolic syndrome (MS). DESIGN Subjects (n=243) were classified into MS+ (n=161) and MS- (n=82) subgroups, based on the AHA/NHBLI criteria. RESULTS Serum anti-Hsp27 titers were found to be significantly higher in the MS+ vs. MS- group. However, no significant difference was observed in serum PAB values. When assessed for individual components of MS, increased serum anti-Hsp27 was found to be higher in subgroups with elevated triglycerides, elevated blood pressure and reduced high-density lipoprotein cholesterol (HDL-C). Subgroups of patients with elevated triglycerides had higher PAB values. HDL-C was the only significant predictor of anti-Hsp27 in the population as a whole. CONCLUSION The evidence from this investigation indicates the presence of elevated anti-Hsp27 in patients with concurrent CAD and MS compared to those with CAD alone