Left Ventricular Hypertrophy in Patients with Renal Artery Stenosis

Left ventricular hypertrophy (LVH) has been shown to be 3 times more prevalent in patients with renal artery stenosis (RAS) compared to essential hypertension, but factors that predict LVH in this population are not known. We identified 66 patients with unilateral renal artery stenosis and an interpretable electrocardiogram (ECG). LVH by either Cornell voltage-duration product or Sokolow-Lyon voltage criteria was present in 18 of the 66 patients (27%). The mean intra-aortic blood pressure was 100 ± 14 mm Hg in patients with LVH, and 104 ± 23 mm Hg in those without LVH (P = 0.37). The average stenosis by quantitative computerized angiography was 68 ± 17% in patients with LVH, and 64 ± 13% in those without LVH (P = 0.34). The mean translesional pressure gradient was 11 ± 15 mm Hg in patients with LVH, and 13 ± 20 mm Hg in those without LVH (P = 0.60). Using linear regression models, there was no correlation between intra-aortic blood pressure, percentage of stenosis, or translesional pressure gradient and either Cornell voltage-duration product or Sokolow-Lyon voltage criteria. In summary, LVH using ECG criteria was present in 27% of patients with unilateral RAS but was not associated with blood pressure at the time of the procedure or severity of renal artery stenosis.