Renal artery stenosis and left ventricular hypertrophy: An updated review and meta-analysis of echocardiographic studies

Aim: Data on left ventricular hypertrophy (LVH) in patients with renal artery stenosis (RAS) and its regression following renal revascularization are scanty. We performed a meta-analysis to provide comprehensive information on this clinically relevant issue. Methods: Full articles providing data on: LVH, as assessed by echocardiography, in RAS patients as compared with essential hypertensive counterparts; changes of left ventricular (LV) mass index after renal artery revascularization were considered. Results: A total of 905 study participants (RAS=446, essential hypertensive=459) of both sex were included in nine studies. Pooled LV mass index was higher in RAS than in essential hypertensive patients (140.4±11.1g/m 2 versus 121.8±6.2g/m 2, standard mean difference being 0.41±0.07 [95% confidence interval (CI) 0.27-0.51, P<0.001]. Among 360 RAS patients undergone renal revascularization from eight studies, baseline and post-intervention pooled mean LV mass index values were 129.0±10.2g/m 2 and 115.5±9.9g/m 2, respectively, the standard mean difference being-0.36±0.06 (95% CI from -0.47 to -0.25, P<0.001). These findings were unaffected by publication bias or single study effect. Conclusion: Our meta-analysis indicates that RAS patients have an increased likelihood of LVH compared with essential hypertensive counterparts and renal artery revascularization has a beneficial effect on LV structure, as reflected by a significant decrease in LV mass index.