Effect of renal denervation on left ventricular mass and function in patients with resistant hypertension: Data from a multi-centre cardiovascular magnetic resonance imaging trial

Felix Mahfoud, Daniel Urban, Desiree Teller, Dominik Linz, Philipp Stawowy, Jan Hendrik Hassel, Peter Fries, Stephan Dreysse, Ernst Wellnhofer, Günther Schneider, Arno Buecker, Christopher Schneeweis, Adelina Doltra, Markus P. Schlaich, Murray D. Esler, Eckart Fleck, Michael Böhm, Sebastian Kelle

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Abstract

Aims: Sympathetic stimulation induces left ventricular hypertrophy and is associated with increased cardiovascular risk. Catheter-based renal denervation (RDN) has been shown to reduce sympathetic outflow and blood pressure (BP). The present multi-centre study aimed to investigate the effect of RDN on anatomic and functional myocardial parameters, assessed by cardiac magnetic resonance (CMR), in patients with resistant hypertension. Methods and results: Cardiac magnetic resonance was performed in 72 patients (mean age 66 ± 10 years) with resistant hypertension (55 patients underwent RDN, 17 served as controls) at baseline and after 6 months. Clinical data and CMR results were analysed blindly. Renal denervation significantly reduced systolic and diastolic BP by 22/8 mm Hg and left ventricular mass index (LVMI) by 7.1% (46.3 ± 13.6 g/m1.7 vs. 43.0 ± 12.6 g/m1.7, P < 0.001) without changes in the control group (41.9 ± 10.8 g/m1.7 vs. 42.0 ± 9.7 g/m1.7, P = 0.653). Ejection fraction (LVEF) in patients with impaired LVEF at baseline (<50%) significantly increased after RDN (43% vs. 50%, P < 0.001). Left ventricular circumferential strain as a surrogate of diastolic function in the subgroup of patients with reduced strain at baseline increased by 21% only in the RDN group (-14.8 vs. -17.9; P = 0.001) and not in control patients (-15.5 vs. -16.4, P = 0.508). Conclusions: Catheter-based RDN significantly reduced BP and LVMI and improved EF and circumferential strain in patients with resistant hypertension, occurring partly BP independently.

Original languageEnglish
Pages (from-to)2224-2231
Number of pages8
JournalEuropean Heart Journal
Volume35
Issue number33
DOIs
Publication statusPublished - 1 Sep 2014
Externally publishedYes

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