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. 2019 Apr;17(4):3255-3263.
doi: 10.3892/etm.2019.7279. Epub 2019 Feb 15.

Renal haemodynamics and coronary atherosclerotic burden are associated in patients with hypertension and mild coronary artery disease

Giulio Geraci  1 , Dario Buccheri  2 , Luca Zanoli  3 , Pasquale Fatuzzo  3 , Katia Di Natale  4 , Marta M Zammuto  1 , Emilio Nardi  1 , Calogero Geraci  5 , Ettore Mancia  1 , Giulia Zambelli  4 , Davide Piraino  4 , Salvatore S Signorelli  3 , Antonio Granata  6 , Santina Cottone  1 , Giuseppe Mule  1
Affiliations

Renal haemodynamics and coronary atherosclerotic burden are associated in patients with hypertension and mild coronary artery disease

Giulio Geraci et al. Exp Ther Med. 2019 Apr.

Abstract

Intrarenal hemodynamic alterations are independent predictors of cardiovascular events in different populations. It has been hypothesized that there is an association between renal hemodynamics and coronary atherosclerotic burden in patients with hypertension. Therefore, the present study examined the associations between renal hemodynamics, coronary atherosclerotic burden and carotid atherosclerotic disease. A total of 130 patients with hypertension aged between 30-80 years who had been referred for an elective coronary angiography were enrolled in the present study. A duplex ultrasound of the intrarenal vasculature was performed to evaluate the resistive index (RI), pulsatility index (PI) and acceleration time (AT). The carotid intima-media thickness was additionally assessed. A coronary angiography was performed to detect the atherosclerotic burden using the Gensini Score (GS). Based on the GS values, subjects were divided into quintiles (I: ≤9; II: 9-17; III: 17-30; IV: 30-44; and V: GS >44) as well as in subjects with mild (GS ≤30) or severe coronary disease (GS >30). A weak significant difference in PI was identified among quintiles (P=0.041), whereas, RI and AT did not differ significantly. PI was associated with GS in the group with low coronary atherosclerotic burden (GS ≤30; P=0.047), whereas, no association was detected in subjects with GS >30. This association remained following adjustment for age and left ventricular ejection fraction (P=0.025). In conclusion, renal vascular alterations were associated with coronary atherosclerotic burden in patients with hypertension with mild coronary disease.

Keywords: Gensini Score; arterial stiffness; atherosclerosis; coronary artery disease; hypertension; renal pulsatility index; renal resistive index.

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Figures

Figure 1.
Figure 1.
(A and B) Carotid intima-media thickness (mean values and standard error) and (C and D) Gensini Score (median and interquartile range) in the population divided into tertiles of renal pulsatility index, and renal resistance index. *P<0.001 vs. Tertile 1.
Figure 2.
Figure 2.
(A) Renal pulsatility index, (B) acceleration time, (C) resistance index and (D) Gensini Score in patients without plaques (AS I), carotid stenosis < 25% (AS II) and carotid stenosis ≥ 25% (AS III). AS, Atherosclerotic Score. *P<0.001 vs. Tertile 1; IIP<0.05 vs. Tertile 1; #P<0.05 vs. Tertile 2.
Figure 3.
Figure 3.
Relationship between Gensini Score and renal pulsatility index (PI) by cubic mathematical model in the overall study population.
See this image and copyright information in PMC

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