Reverse cardiac remodelling and renal functional improvement following bilateral renal artery stenting for flash pulmonary oedema.
Nephrol Dial Transplant
; 28(2): 479-83, 2013 Feb.
Article
em En
| MEDLINE
| ID: mdl-22262735
ABSTRACT
Acute flash pulmonary oedema (AFPO) is a life-threatening syndrome almost unique to patients with atheromatous renovascular disease (ARVD). Although recurrent AFPO is a widely accepted indication to consider renal revascularization, this is based on a number of case reports/series describing a successful outcome post-procedure. There is limited literature on the pathophysiological mechanisms and treatment effects of revascularization to support this clinical decision making. We report the case of a 65-year-old lady who presented with three episodes of AFPO. Investigations revealed severe bilateral renal artery stenosis. Post-revascularization, she experienced substantial improvement in energy levels and New York Heart Association class, with improvement in her blood pressure and renal function. Post-procedure, there were dramatic improvements in her cardiac morphology and function that were sustained at 1 year (ejection fraction improved from 39 to 65%, left ventricular mass decreased from 161 to 116 g) as well as renal function (isotopic glomerular filtration rate increased from 22.4 to 34.2 mL/min). This report provides new insights into the pathophysiological relationships between renal and cardiac changes in AFPO; the extent of the cardiac morphological changes was striking and unexpected.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Edema Pulmonar
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Obstrução da Artéria Renal
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Procedimentos Cirúrgicos Vasculares
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Stents
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Remodelação Ventricular
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Rim
Tipo de estudo:
Etiology_studies
/
Prognostic_studies
Limite:
Aged
/
Female
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Humans
Idioma:
En
Ano de publicação:
2013
Tipo de documento:
Article