Veglio F, Frascisco M, Melchio R, Provera E, Rabbia F, Oliva
S, Chiandussi L
Assessment of renal resistance index after captopril test by
Doppler in essential and renovascular hypertension
(Nov) 48:1611-1616 1995
The optimal test to screen for renovascular hypertension is unclear.
Ultrasonic duplex scanning can detect renal artery stenosis (RAS); however,
its utility in demonstrating functional significance of stenotic lesions has
not previously been studied. 22 patients with renovascular hypertension
(unilateral RAS on angiography with positive captopril test and abnormal
captopril scintigraphy), 45 essential hypertensives, and 15 normotensives
Doppler parameter resistance indices (RI) measured before and after 50 mg
captopril. The RI (quantitation of arterial impedance) was measured at the
hilum and in at least three interlobar arteries. RI was calculated using
following formula: (peak systolic frequency shift - lowest diastolic
frequency shift)/peak systolic frequency shift. The RI decreased more after
captopril in renovascular vs. essential hypertensive patients. Sensitivity
and specificity of this method for detection of unilateral RAS were 93 and
91%, respectively. Duplex Doppler appears to be a good screening test for
renovascular hypertension in centers experienced with this procedure.
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