Hemodynamic Responses to Acute and Gradual Renal Artery Stenosis in Pigs

被引:15
作者
Rognant, Nicolas [1 ,2 ]
Rouviere, Olivier [1 ]
Janier, Marc [3 ]
Quoc Hung Le [4 ]
Barthez, Paul [5 ]
Laville, Maurice [1 ,2 ]
Juillard, Laurent [1 ,2 ]
机构
[1] Hosp Civils Lyon, Hop Edouard Herriot, Dept Nephrol, Lyon, France
[2] Univ Lyon 1, INSERM ERI 22, F-69365 Lyon, France
[3] Hosp Civils Lyon, Hop Edouard Herriot, Dept Nucl Med, Lyon, France
[4] Hosp Civils Lyon, Dept Biostat, Lyon, France
[5] Ecole Natl Vet Lyon, Dept Radiol, Marcy Letoile, France
关键词
blood pressure; hypertension; ischemic renal disease; renal artery stenosis; renal blood flow; renin; renovascular hypertension; swine; ISCHEMIC NEPHROPATHY; HYPERTENSION; DOG;
D O I
10.1038/ajh.2010.147
中图分类号
R6 [外科学];
学科分类号
1002 ; 100210 ;
摘要
BACKGROUND Reduction of renal blood flow (RBF) due to a renal artery stenosis (RAS) can lead to renal ischemia and atrophy. However in pigs, there are no data describing the relationship between the degree of RAS, the reduction of RBF, and the increase of systemic plasma renin activity (PRA). Therefore, we conducted a study in order to measure the effect of acute and gradual RAS on RBF, mean arterial pressure (MAP), and systemic PRA in pigs. METHODS RAS was induced experimentally in six pigs using an occluder placed around the renal artery downstream of an ultrasound flow probe. The vascular occluder was inflated gradually to reduce RBF. At each inflation step, percentage of RAS was measured by digital substraction angiography (DSA) with simultaneous measurements of RBF, MAP, and PRA. Data were normalized to baseline values obtained before RAS induction. Piecewise regression analysis was performed between percentage of RAS and relative RBF, MAP, and PRA, respectively. RESULTS In all pigs, the relationship between the degree of RAS and RBF was similar. RBF decreased over a threshold of 42% of RAS, with a rapid drop in RBF when RAS reached 70%. PRA increased dramatically over a threshold of 58% of RAS (+1,300% before occlusion). MAP increased slightly (+15% before occlusion) without identifiable threshold. CONCLUSIONS This study emphasizes that the relation between the degree of RAS and RBF and systemic PRA is not linear and that a high degree of RAS must be reached before the occurrence of significant hemodynamic and humoral effects.
引用
收藏
页码:1216 / 1219
页数:4
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