Impact of Renal Sympathetic Denervation on Left Ventricular Structure and Function at 1-Year Follow-Up

Manuel de Sousa Almeida; Pedro de Araújo Gonçalves; Patricia Branco; João Mesquita; Maria Salomé Carvalho; Helder Dores; Henrique Silva Sousa; Augusta Gaspar; Eduarda Horta; Ana Aleixo; Nuno Neuparth; Miguel Mendes; Maria João Andrade

doi:10.1371/journal.pone.0149855

Impact of Renal Sympathetic Denervation on Left Ventricular Structure and Function at 1-Year Follow-Up

Manuel de Sousa Almeida, Pedro de Araújo Gonçalves, Patricia Branco, João Mesquita, Maria Salomé Carvalho, Helder Dores, Henrique Silva Sousa, Augusta Gaspar, Eduarda Horta, Ana Aleixo, Nuno Neuparth, Miguel Mendes, Maria João Andrade

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Abstract

BACKGROUND: Catheter-based sympathetic renal denervation (RDN) is a recent therapeutic option for patients with resistant hypertension. However, the impact of RDN in left ventricular (LV) mass and function is not completely established. Our aim was to evaluate the effects of RDN on LV structure and function (systolic and diastolic) in patients with resistant hypertension (HTN).

METHODS AND RESULTS: From a single centre prospective registry including 65 consecutive patients with resistant HTN submitted to RDN between July-2011 and April-2015, 31 patients with baseline and 1-year follow-up echocardiogram were included in this analysis. Mean age was 65 ± 7 years, 48% were males, 71% had type 2 diabetes. Most had hypertension lasting for more than 10 years (90%), and were being treated with a median number of 6 anti-hypertensive drugs, including 74% on spironolactone. At 1-year, there was a significant decrease both on office SBP (176 ± 24 to 149 ± 13 mmHg, p<0.001) and DBP (90 ± 14 to 79 ± 11 mmHg, p<0.001), and also in 24h ABPM SBP (150 ± 20 to 132 ± 14 mmhg, p<0.001) and DBP (83 ± 10 to 74 ± 9 mmHg, p<0.001). There was also a significant decrease in LV mass from 152 ± 32 to 136 ± 34 g/m(2) (p<0.001), an increase in LV end diastolic volume (93 ± 18 to 111 ± 27 mL, p = 0.004), an increase in LV ejection fraction (65 ± 9 to 68 ± 9%, p = 0.001) and mitral valve E deceleration time (225 ± 49 to 247 ± 51 ms, p = 0.015) at 1-year follow up. There were no significant changes in left atrium volume index or in the distribution of patients among the different left ventricle geometric patterns and diastolic function subgroups.

CONCLUSIONS: In this single centre registry of patients with resistant hypertension, renal denervation was associated with significant reduction in both office and ABPM blood pressure and a significant decrease in left ventricle mass evaluated by transthoracic echocardiogram at 1 year follow-up.

Original language	English
Pages (from-to)	e0149855
Journal	PLoS ONE
Volume	11
Issue number	3
DOIs	https://doi.org/10.1371/journal.pone.0149855
Publication status	Published - 2016

Keywords

Aged
Antihypertensive Agents
Blood Pressure
Blood Pressure Determination
Blood Pressure Monitoring, Ambulatory
Diabetes Mellitus, Type 2
Diastole
Female
Follow-Up Studies
Heart Ventricles
Humans
Hypertension
Hypertrophy, Left Ventricular
Kidney
Male
Prospective Studies
Sympathectomy
Sympathetic Nervous System
Systole
Ventricular Function, Left
Journal Article

UN SDGs

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de Sousa Almeida, M., Gonçalves, P. D. A., Branco, P., Mesquita, J., Carvalho, M. S., Dores, H., Silva Sousa, H., Gaspar, A., Horta, E., Aleixo, A., Neuparth, N., Mendes, M., & Andrade, M. J. (2016). Impact of Renal Sympathetic Denervation on Left Ventricular Structure and Function at 1-Year Follow-Up. PLoS ONE, 11(3), e0149855. https://doi.org/10.1371/journal.pone.0149855

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title = "Impact of Renal Sympathetic Denervation on Left Ventricular Structure and Function at 1-Year Follow-Up",

abstract = "BACKGROUND: Catheter-based sympathetic renal denervation (RDN) is a recent therapeutic option for patients with resistant hypertension. However, the impact of RDN in left ventricular (LV) mass and function is not completely established. Our aim was to evaluate the effects of RDN on LV structure and function (systolic and diastolic) in patients with resistant hypertension (HTN).METHODS AND RESULTS: From a single centre prospective registry including 65 consecutive patients with resistant HTN submitted to RDN between July-2011 and April-2015, 31 patients with baseline and 1-year follow-up echocardiogram were included in this analysis. Mean age was 65 ± 7 years, 48% were males, 71% had type 2 diabetes. Most had hypertension lasting for more than 10 years (90%), and were being treated with a median number of 6 anti-hypertensive drugs, including 74% on spironolactone. At 1-year, there was a significant decrease both on office SBP (176 ± 24 to 149 ± 13 mmHg, p<0.001) and DBP (90 ± 14 to 79 ± 11 mmHg, p<0.001), and also in 24h ABPM SBP (150 ± 20 to 132 ± 14 mmhg, p<0.001) and DBP (83 ± 10 to 74 ± 9 mmHg, p<0.001). There was also a significant decrease in LV mass from 152 ± 32 to 136 ± 34 g/m(2) (p<0.001), an increase in LV end diastolic volume (93 ± 18 to 111 ± 27 mL, p = 0.004), an increase in LV ejection fraction (65 ± 9 to 68 ± 9%, p = 0.001) and mitral valve E deceleration time (225 ± 49 to 247 ± 51 ms, p = 0.015) at 1-year follow up. There were no significant changes in left atrium volume index or in the distribution of patients among the different left ventricle geometric patterns and diastolic function subgroups.CONCLUSIONS: In this single centre registry of patients with resistant hypertension, renal denervation was associated with significant reduction in both office and ABPM blood pressure and a significant decrease in left ventricle mass evaluated by transthoracic echocardiogram at 1 year follow-up.",

keywords = "Aged, Antihypertensive Agents, Blood Pressure, Blood Pressure Determination, Blood Pressure Monitoring, Ambulatory, Diabetes Mellitus, Type 2, Diastole, Female, Follow-Up Studies, Heart Ventricles, Humans, Hypertension, Hypertrophy, Left Ventricular, Kidney, Male, Prospective Studies, Sympathectomy, Sympathetic Nervous System, Systole, Ventricular Function, Left, Journal Article",

author = "{de Sousa Almeida}, Manuel and Gon{\c c}alves, {Pedro de Ara{\'u}jo} and Patricia Branco and Jo{\~a}o Mesquita and Carvalho, {Maria Salom{\'e}} and Helder Dores and {Silva Sousa}, Henrique and Augusta Gaspar and Eduarda Horta and Ana Aleixo and Nuno Neuparth and Miguel Mendes and Andrade, {Maria Jo{\~a}o}",

year = "2016",

doi = "10.1371/journal.pone.0149855",

language = "English",

volume = "11",

pages = "e0149855",

journal = "PLoS ONE",

issn = "1932-6203",

publisher = "PLOS - Public Library of Science",

number = "3",

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TY - JOUR

T1 - Impact of Renal Sympathetic Denervation on Left Ventricular Structure and Function at 1-Year Follow-Up

AU - de Sousa Almeida, Manuel

AU - Gonçalves, Pedro de Araújo

AU - Branco, Patricia

AU - Mesquita, João

AU - Carvalho, Maria Salomé

AU - Dores, Helder

AU - Silva Sousa, Henrique

AU - Gaspar, Augusta

AU - Horta, Eduarda

AU - Aleixo, Ana

AU - Neuparth, Nuno

AU - Mendes, Miguel

AU - Andrade, Maria João

PY - 2016

Y1 - 2016

N2 - BACKGROUND: Catheter-based sympathetic renal denervation (RDN) is a recent therapeutic option for patients with resistant hypertension. However, the impact of RDN in left ventricular (LV) mass and function is not completely established. Our aim was to evaluate the effects of RDN on LV structure and function (systolic and diastolic) in patients with resistant hypertension (HTN).METHODS AND RESULTS: From a single centre prospective registry including 65 consecutive patients with resistant HTN submitted to RDN between July-2011 and April-2015, 31 patients with baseline and 1-year follow-up echocardiogram were included in this analysis. Mean age was 65 ± 7 years, 48% were males, 71% had type 2 diabetes. Most had hypertension lasting for more than 10 years (90%), and were being treated with a median number of 6 anti-hypertensive drugs, including 74% on spironolactone. At 1-year, there was a significant decrease both on office SBP (176 ± 24 to 149 ± 13 mmHg, p<0.001) and DBP (90 ± 14 to 79 ± 11 mmHg, p<0.001), and also in 24h ABPM SBP (150 ± 20 to 132 ± 14 mmhg, p<0.001) and DBP (83 ± 10 to 74 ± 9 mmHg, p<0.001). There was also a significant decrease in LV mass from 152 ± 32 to 136 ± 34 g/m(2) (p<0.001), an increase in LV end diastolic volume (93 ± 18 to 111 ± 27 mL, p = 0.004), an increase in LV ejection fraction (65 ± 9 to 68 ± 9%, p = 0.001) and mitral valve E deceleration time (225 ± 49 to 247 ± 51 ms, p = 0.015) at 1-year follow up. There were no significant changes in left atrium volume index or in the distribution of patients among the different left ventricle geometric patterns and diastolic function subgroups.CONCLUSIONS: In this single centre registry of patients with resistant hypertension, renal denervation was associated with significant reduction in both office and ABPM blood pressure and a significant decrease in left ventricle mass evaluated by transthoracic echocardiogram at 1 year follow-up.

AB - BACKGROUND: Catheter-based sympathetic renal denervation (RDN) is a recent therapeutic option for patients with resistant hypertension. However, the impact of RDN in left ventricular (LV) mass and function is not completely established. Our aim was to evaluate the effects of RDN on LV structure and function (systolic and diastolic) in patients with resistant hypertension (HTN).METHODS AND RESULTS: From a single centre prospective registry including 65 consecutive patients with resistant HTN submitted to RDN between July-2011 and April-2015, 31 patients with baseline and 1-year follow-up echocardiogram were included in this analysis. Mean age was 65 ± 7 years, 48% were males, 71% had type 2 diabetes. Most had hypertension lasting for more than 10 years (90%), and were being treated with a median number of 6 anti-hypertensive drugs, including 74% on spironolactone. At 1-year, there was a significant decrease both on office SBP (176 ± 24 to 149 ± 13 mmHg, p<0.001) and DBP (90 ± 14 to 79 ± 11 mmHg, p<0.001), and also in 24h ABPM SBP (150 ± 20 to 132 ± 14 mmhg, p<0.001) and DBP (83 ± 10 to 74 ± 9 mmHg, p<0.001). There was also a significant decrease in LV mass from 152 ± 32 to 136 ± 34 g/m(2) (p<0.001), an increase in LV end diastolic volume (93 ± 18 to 111 ± 27 mL, p = 0.004), an increase in LV ejection fraction (65 ± 9 to 68 ± 9%, p = 0.001) and mitral valve E deceleration time (225 ± 49 to 247 ± 51 ms, p = 0.015) at 1-year follow up. There were no significant changes in left atrium volume index or in the distribution of patients among the different left ventricle geometric patterns and diastolic function subgroups.CONCLUSIONS: In this single centre registry of patients with resistant hypertension, renal denervation was associated with significant reduction in both office and ABPM blood pressure and a significant decrease in left ventricle mass evaluated by transthoracic echocardiogram at 1 year follow-up.

KW - Aged

KW - Antihypertensive Agents

KW - Blood Pressure

KW - Blood Pressure Determination

KW - Blood Pressure Monitoring, Ambulatory

KW - Diabetes Mellitus, Type 2

KW - Diastole

KW - Female

KW - Follow-Up Studies

KW - Heart Ventricles

KW - Humans

KW - Hypertension

KW - Hypertrophy, Left Ventricular

KW - Kidney

KW - Male

KW - Prospective Studies

KW - Sympathectomy

KW - Sympathetic Nervous System

KW - Systole

KW - Ventricular Function, Left

KW - Journal Article

U2 - 10.1371/journal.pone.0149855

DO - 10.1371/journal.pone.0149855

M3 - Article

C2 - 26934735

SN - 1932-6203

VL - 11

SP - e0149855

JO - PLoS ONE

JF - PLoS ONE

IS - 3

ER -

Impact of Renal Sympathetic Denervation on Left Ventricular Structure and Function at 1-Year Follow-Up

Abstract

Keywords

UN SDGs

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