Prognostic Value of Captopril Renal Scintigraphy in Renovascular Hypertension

This study evaluates the prognostic value of captopnl renal scintigraphyin hypertensivepatients undergoingrenal artery revascularization.Preoperativestudies of 51 patients were correlatedwith blood pressureresults at 6- and 12-mofollow up.Captopnl-renai scintigraphy wascarriedout 1 hrafteroral administrationof 50 mg of captopril, using either 220 MBq of @Tc-DTPA or 74 MBqof @Tc-MAG3, followedby a baseline study in case of abnormal results. Evidenceof amelioration or normalizationin relationto captopril study was considered predictive of blood pressure control following treatment. Blood pressure response was favorable in 37 patients, but failed to show any improvement in 14. The scintigraphic test was positive in 33 patients (15 cured, 17 improved, 1 failed) and negativein 18 (3 cured, 2 improved,13 failed).Sensitivity and Specfficityfor renovascularhypertensionwas 86.5% and 93%, respectively.For bloodpressurecure and improvement, the test had positive and negative predictive values of 97% and72%,respectively. Apositive preoperative captopril renal scantigraphicresuft is a strong predictor of hypertensioncur ability by renalartery revascularization. J NucIMed 1992;33:2040-2044