IMR Press / FBE / Volume 4 / Issue 3 / DOI: 10.2741/E424

Frontiers in Bioscience-Elite (FBE) is published by IMR Press from Volume 13 Issue 2 (2021). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with Frontiers in Bioscience.

Open Access Review

The heart in atherosclerotic renovascular disease

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1 Salford Royal Hospital, Stott Lane, M6 8HD, UK

*Author to whom correspondence should be addressed.

Academic Editor: Sunil Bhandari

Front. Biosci. (Elite Ed) 2012, 4(3), 856–864; https://doi.org/10.2741/E424
Published: 1 January 2012
(This article belongs to the Special Issue Cardiac remodelling in uraemic heart disease)
Abstract

Atherosclerotic renovascular disease (ARVD) is associated with a high rate of cardiovascular disease and mortality. ARVD is an independent risk factor for adverse outcome in coronary artery disease and there is a correlation between the presence of ARVD and severity of cardiovascular disease. ARVD is the most common cause of secondary hypertension and can be found in up to half of elderly patients with chronic heart failure. Abnormal cardiac structure and / or function will be present in 95% of ARVD patients, with left ventricular hypertrophy (LVH) and diastolic dysfunction the predominant abnormalities. These are likely to be due in part to over-activity of the renin-angiotensin pathway. Up to now, randomised trials have shown no benefit of renal artery revascularisation over medical therapy in terms of cardiovascular events but small case series clearly demonstrate situations where cardiac structure and function respond to revascularisation. Future strategies must focus on accurately identifying sub-groups of ARVD patients for whom revascularisation should be first line therapy.

Keywords
Renal Artery Stenosis
Heart Failure
Revascularisation
Pulmonary Oedema
Cardiovascular
Chronic Kidney Disease
Review
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