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EFFECTS OF DISTAL RENAL DENERVATION VERSUS CONVENTIONAL INTERVENTION ON THE HEART IN PATIENTS WITH RESISTANT HYPERTENSION

Ripp, T.; Pekarskiy, S.; Ryabova, T.; Mordovin, V.; Baev, A.; Lichikaky, V.; Sitkova, E.; Popov, S.

Journal of Hypertension: June 2018 - Volume 36 - Issue - p e24
doi: 10.1097/01.hjh.0000539027.16061.59
ORAL SESSION 3C: RESISTANT HYPERTENSION: PDF Only
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Objective: The aim of this study was to evaluate of state the heart after distal renal denervation (DRD) in segmental branches of renal artery versus conventional main trunk therapy: 12 month study in patients with resistant hypertension (RH).

Design and method: All participants of research have given the informed agreement. This was a double-blind, randomized prospective study (NCT01499810) in 55 patients meeting criteria of true RH. Patients were randomized either to endovascular “conventional” renal denervation (CRD) of the main renal arteria (n = 27) or to distal (D) treatment applied in segmental branches after the bifurcation of the main renal arteria (n = 28). Echocardiography was making from standards method. It was protocol ASE-convention. Parameters of office BP, IVS - interventricular septum, PSV - posterior wall of the left ventricle, LA - left atrium, LVM - left ventricular mass, and myocardial stress (MS) were performed at baseline and 12 months follow-up. Statistical analysis: descriptive, t-test independent by groups, t-test dependent samples.

Results: Forty six patients completed 12 month follow-up: after CRD (n = 24) and after DRD (n = 22). A significantly greater decreased parameters of 24-hour BP (-11.5 ± 16.3 vs -22.0 ± 20.3 mm Hg, p < 0.05) and the left ventricle of heart: IVS - interventricular septum (-0.21 ± 1.3 vs -1.2 ± 1.8 p < 0.05 mm), PSV - posterior wall of the left ventricle (0.20 ± 1.2 vs -0.86 ± 1.7 p < 0.05 mm), LA - left atrium (0.96 ± 2.8 vs -1.36 ± 9.6 p > 0.05 mm), LVM - left ventricular mass (-4.9 ± 37.4 vs -36.3 ± 34.5 p < 0.05 g), and MS (-1784.0 ± 2294 vs -5133.6 ± 1556.2 p < 0.05 dynes / cm2) were performed at baseline and 12 months follow-up.

Conclusions: Distal RD treatment applied in segmental branches after the bifurcation of the main renal arteria compared with “conventional” renal denervation in in the main trunk of the renal artery further reduces myocardial stress, as well as a positive impact on the parameters of the left ventricle, but not the left atrium 12 months after renal denervation in patients with resistant hypertension.

Cardiology Research Institute, Tomsk NRMC, Tomsk, RUSSIA.

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