Evidence map›Paper›PMID 31200662›Full record

Trial reportBMC nephrology2019

Cardiac structure and function after revascularization versus medical therapy for renal artery stenosis: the ASTRAL heart echocardiographic sub-study.

Darren Green, Diana Vassallo, Kelly Handley, Natalie Ives, Keith Wheatley, Constantina Chrysochou, Janet Hegarty, Julian Wright, Jon Moss, Rajan K Patel and 9 more

Open access · goldAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
In one paragraph

Trial report in BMC nephrology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.3field-weighted citation impact, top 35% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 4 citations in OpenAlex.

  1. Review
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors at 10 institutions in 1 country.

Darren GreenDepartment of Renal Medicine, Salford Royal NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK. darrengreen@doctors.org.uk.
Diana VassalloDepartment of Renal Medicine, Salford Royal NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK.
Kelly HandleyUniversity of Birmingham, Birmingham, UK.
Natalie IvesUniversity of Birmingham, Birmingham, UK.
Keith WheatleyUniversity of Birmingham, Birmingham, UK.
Constantina ChrysochouDepartment of Renal Medicine, Salford Royal NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK.
Janet HegartyDepartment of Renal Medicine, Salford Royal NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK.
Julian WrightManchester Foundation Trust, Manchester, UK.
Jon MossWestern Infirmary, Glasgow, UK.
Rajan K PatelWestern Infirmary, Glasgow, UK.
Chris DeighanGlasgow Royal Infirmary, Glasgow, UK.
John WebsterAberdeen Royal Infirmary, Aberdeen, UK.
Peter RoweDerriford Hospital, Plymouth, UK.
Sue CarrUniversity Hospitals of Leicester, Leicester, UK.
Jenny CrossRoyal Free Hospital, London, UK.
Jamie O'DriscollSt George's Hospital, London, UK.
Raj SharmaSt George's Hospital, London, UK.
Patrick MarkInstitute of Cardiovascular and Medical Science, University of Glasgow, Glasgow, UK.
Philip A KalraDepartment of Renal Medicine, Salford Royal NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK.
Salford Royal NHS Foundation Trust · GBUniversity of Birmingham · GBSt George's Hospital · GBWestern Infirmary · GBAberdeen Royal Infirmary · GBDerriford Hospital · GBGlasgow Royal Infirmary · GBUniversity College London · GBUniversity Hospitals of Leicester NHS Trust · GBUniversity of Glasgow · GB

Funding

Medical Research Council
6 · The paper itself

Abstract

backgroundThe ASTRAL trial showed no difference in clinical outcomes between medical therapy and revascularization for atherosclerotic renal vascular disease (ARVD). Here we report a sub-study using echocardiography to assess differences in cardiac structure and function at 12 months.

methodsASTRAL patients from 7 participating centres underwent echocardiography at baseline and 12 months after randomisation. Changes in left ventricular ejection fraction (LVEF), left ventricular mass (LVM), left atrial diameter (LAD), aortic root diameter (AoRD), E:A, and E deceleration time (EDT) were compared between study arms. Analyses were performed using t-tests and multivariate linear regression.

resultsNinety two patients were included (50 medical versus 42 revascularization). There was no difference between arms in any baseline echocardiographic parameter. Comparisons of longitudinal changes in echocardiographic measurements were: δLVEF medical 0.8 ± 8.7% versus revascularization - 2.8 ± 6.8% (p = 0.05), δLVM - 2.9 ± 33 versus - 1.7 ± 39 g (p = 0.9), δLAD 0.1 ± 0.4 versus 0.01 ± 0.5 cm (p = 0.3), δAoRD 0.002 ± 0.3 versus 0.06 ± 0.3 cm (p = 0.4), δE:A - 0.0005 ± 0.6 versus 0.03 ± 0.7 (p = 0.8), δEDT - 1.1 ± 55.5 versus - 9.0 ± 70.2 ms (p = 0.6). In multivariate models, there were no differences between treatment groups for any parameter at 12 months. Likewise, change in blood pressure did not differ between arms (mean δsystolic blood pressure medical 0 mmHg [range - 56 to + 54], revascularization - 3 mmHg [- 61 to + 59], p = 0.60).

conclusionsThis sub-study did not show any significant differences in cardiac structure and function accompanying renal revascularization in ASTRAL. Limitations include the small sample size, the relative insensitivity of echocardiography, and the fact that a large proportion of ASTRAL patient population had only modest renal artery stenosis as described in the main study.

Indexed as

AgedAged, 80 and overEchocardiographyFemaleHumansLongitudinal StudiesMaleMiddle AgedRenal Artery ObstructionStroke VolumeVascular Surgical ProceduresVentricular Function, LeftEchocardiographyLeft ventricular hypertrophyRandomized controlled trialRenal artery stenosisRevascularization

Identifiers

PMID31200662
PMCPMC6570952
OpenAlexW2952804130

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.