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 languageEnglish
Pages (from-to)e0149855
JournalPlosOne
Volume11
Issue number3
DOIs
Publication statusPublished - 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

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