Document Detail


"Apparent" heart failure: a syndrome caused by renal artery stenoses.
MedLine Citation:
PMID:  10648486     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To report on renal artery stenosis presenting as congestive heart failure. DESIGN: Case series. SETTING: Tertiary referral centre. PATIENTS: Nine hypertensive subjects (five male, four female) seen in the blood pressure unit, St George's Hospital, between 1991 and 1997 with clinical signs and symptoms of congestive cardiac failure but without overt coronary or valvar heart disease. Mean (SEM) age was 67 (3) years. Eight patients had renal artery revascularisation with percutaneous angioplasty and one had surgery. RESULTS: Renal revascularisation was followed by a large fall in blood pressure from 191/94 (7/3) to 150/75 (8/5) mm Hg two days after intervention (p < 0.01). There was also a large natriuresis and weight reduction. One week after revascularisation there was a mean loss in weight of 3.8 (0.6) kg. The largest fall in weight was seen in those patients with stenosis in a single functioning kidney. Furthermore, plasma atrial natriuretic factor fell from 120 (28) to 48 (9) pg/ml (p < 0.05; n = 6; normal value = 8.6 (0.8) pg/ml), and serum creatinine fell from 200 (37) to 140 (11) micromol/l (p < 0. 025). The clinical signs and symptoms of heart failure resolved and the diuretics were then withdrawn in all patients. On long term follow up, patients remained free from symptoms and signs of heart failure and the blood pressure was better controlled. CONCLUSIONS: In hypertensive patients with symptoms and signs of congestive heart failure who do not have obvious ischaemic or valvar heart disease, renal artery stenosis should be considered as a possible underlying cause. Relief of the stenosis can result in resolution of the apparent heart failure.
Authors:
C G Missouris; A M Belli; G A MacGregor
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Heart (British Cardiac Society)     Volume:  83     ISSN:  1355-6037     ISO Abbreviation:  Heart     Publication Date:  2000 Feb 
Date Detail:
Created Date:  2000-03-27     Completed Date:  2000-03-27     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  9602087     Medline TA:  Heart     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  152-5     Citation Subset:  AIM; IM    
Affiliation:
St George's Hospital Medical School, Cranmer Terrace, London SW17 0RE, UK.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty
Diagnosis, Differential
Female
Heart Failure / etiology*,  surgery
Humans
Hypertension / etiology*,  surgery
Male
Middle Aged
Renal Artery Obstruction / complications*,  surgery
Weight Loss
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