Diagnostic role of new Doppler index in assessment of renal artery stenosis

Background: Renal artery stenosis (RAS) is one of the main causes of secondary systemic arterial hypertension. Several non-invasive diagnostic methods for RAS have been used in hypertensive patients, such as color Doppler ultrasound (US). The aim of this study was to assess the sensitivity and speci...

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Autores principales: Chain, Sergio, Luciardi, Héctor, Feldman, Gabriela, Berman, Sofía, Herrera, Ramón N., Ochoa, Javier, Muntaner, Juan, Escudero, Eduardo Manuel, Ronderos, Ricardo E.
Formato: Articulo
Lenguaje:Inglés
Publicado: 2006
Materias:
Acceso en línea:http://sedici.unlp.edu.ar/handle/10915/37658
http://www.cardiovascularultrasound.com/content/pdf/1476-7120-4-4.pdf
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id I19-R120-10915-37658
record_format dspace
institution Universidad Nacional de La Plata
institution_str I-19
repository_str R-120
collection SEDICI (UNLP)
language Inglés
topic Ciencias Médicas
arteriography
disease severity
hypertension
spellingShingle Ciencias Médicas
arteriography
disease severity
hypertension
Chain, Sergio
Luciardi, Héctor
Feldman, Gabriela
Berman, Sofía
Herrera, Ramón N.
Ochoa, Javier
Muntaner, Juan
Escudero, Eduardo Manuel
Ronderos, Ricardo E.
Diagnostic role of new Doppler index in assessment of renal artery stenosis
topic_facet Ciencias Médicas
arteriography
disease severity
hypertension
description Background: Renal artery stenosis (RAS) is one of the main causes of secondary systemic arterial hypertension. Several non-invasive diagnostic methods for RAS have been used in hypertensive patients, such as color Doppler ultrasound (US). The aim of this study was to assess the sensitivity and specificity of a new renal Doppler US direct-method parameter: the renal-renal ratio (RRR), and compare with the sensitivity and specificity of direct-method conventional parameters: renal peak systolic velocity (RPSV) and renal aortic ratio (RAR), for the diagnosis of severe RAS. Methods: Our study group included 34 patients with severe arterial hypertension (21 males and 13 females), mean age 54 (± 8.92) years old consecutively evaluated by renal color Doppler ultrasound (US) for significant RAS diagnosis. All of them underwent digital subtraction arteriography (DSA). RAS was significant if a diameter reduction < 50% was found. The parameters measured were: RPSV, RAR and RRR. The RRR was defined as the ratio between RPSV at the proximal or mid segment of the renal artery and RPSV measured at the distal segment of the renal artery. The sensitivity and specificity cutoff for the new RRR was calculated and compared with the sensitivity and specificity of RPSV and RAR. Results: The accuracy of the direct method parameters for significant RAS were: RPSV >200 cm/s with 97% sensitivity, 72% specificity, 81% positive predictive value and 95% negative predictive value; RAR >3 with 77% sensitivity, 90% specificity, 90% positive predictive value and 76% negative predictive value. The optimal sensitivity and specificity cutoff for the new RRR was >2.7 with 97% sensitivity (p < 0.004) and 96% specificity (p < 0.02), with 97% positive predictive value and 97% negative predictive value. Conclusion: The new RRR has improved specificity compared with the direct method conventional parameters (RPSV >200cm/s and RAR >3). Both RRR and RPSV show better sensitivity than RAR for the RAS diagnosis.
format Articulo
Articulo
author Chain, Sergio
Luciardi, Héctor
Feldman, Gabriela
Berman, Sofía
Herrera, Ramón N.
Ochoa, Javier
Muntaner, Juan
Escudero, Eduardo Manuel
Ronderos, Ricardo E.
author_facet Chain, Sergio
Luciardi, Héctor
Feldman, Gabriela
Berman, Sofía
Herrera, Ramón N.
Ochoa, Javier
Muntaner, Juan
Escudero, Eduardo Manuel
Ronderos, Ricardo E.
author_sort Chain, Sergio
title Diagnostic role of new Doppler index in assessment of renal artery stenosis
title_short Diagnostic role of new Doppler index in assessment of renal artery stenosis
title_full Diagnostic role of new Doppler index in assessment of renal artery stenosis
title_fullStr Diagnostic role of new Doppler index in assessment of renal artery stenosis
title_full_unstemmed Diagnostic role of new Doppler index in assessment of renal artery stenosis
title_sort diagnostic role of new doppler index in assessment of renal artery stenosis
publishDate 2006
url http://sedici.unlp.edu.ar/handle/10915/37658
http://www.cardiovascularultrasound.com/content/pdf/1476-7120-4-4.pdf
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