AnalyzeDirect

Coronary artery disease occurs when the arteries that supply blood to the heart become hardened and narrowed (stenosis) due to the accumulation of cholesterol and other fatty substances on their inner walls. The restriction in blood supply causes a shortage of oxygen and glucose to the heart that may not only impact the myocardial tissue, but also impair remote organs.

In fact, this heart condition often correlates with hypertension, which can lead to chronic kidney disease, narrowing of the renal artery and subsequent renovascular hypertension. It is yet not fully understood, however, whether coronary artery stenosis alone, regardless of plaque deposition (atherosclerosis), may lead to renal injury. Another question that needs to be answered is whether nonatherosclerotic narrowing of the artery increases kidney vulnerability to coexisting hypertension.

In order to address these issues, researchers from Mayo Clinic investigated the relationship between coronary artery disease and kidney injury. They induced coronary artery stenosis by implanting coils in the coronary arteries of pigs. The animals were randomized to four groups: controls, pigs with coronary artery stenosis, pigs with hypertension and pigs with both coronary artery stenosis and hypertension.

From CT scans, Analyze software was used to perform heart segmentation, measure the degree of arterial narrowing and assess cardiac and renal function. Histological tests were also carried out to investigate renal fibrosis. The results of this study indicate that nonatherosclerotic coronary artery stenosis increased renal inflammation, oxidative stress, microvascular remodeling and fibrosis, causing renal injury and dysfunction. Moreover, the combination of coronary artery narrowing and hypertension further deteriorated renal microvascular blood flow through intensified inflammation and oxidative stress, increasing the risk of renal failure.

These findings indicate an interaction between cardiac and renal function regardless of the atherosclerotic burden. Further studies are needed to fully understand this relationship in order to ensure adequate treatment in patients with concurrent coronary artery stenosis and hypertension.

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Tags: Heart Disease, Kidney Disease