Comparative analysis of cardioprotective effects of two renal denervation techniques

Aim . To compare cardioprotective effects of two renal denervation (RD) techniques: main renal artery or its branches after bifurcation in patients with resistant hypertension (RH). Materials and methods . This randomized double-blind clinical (ClinicalTrials. gov. identifier: NCT02667912) study wit...

Full description

Saved in:

Bibliographic Details
Published in:	Rossiĭskiĭ kardiologicheskiĭ zhurnal Vol. 25; no. 12; p. 3994
Main Authors:	Ripp, T. M., Pekarskiy, S. E., Baev, A. E., Ryabova, T. R., Yaroslavskay, E. I., Falkovskaya, A. Yu, Sitkova, E. S., Lichikaki, V. A., Zubanova, I. V., Manukian, M. A., Gapon, L. I., Mordovin, V. F.
Format:	Journal Article
Language:	English
Published:	FIRMA «SILICEA» LLC 30-12-2020
Subjects:	diastolic function heart hypertension renal denervation
Online Access:	Get full text
Tags:	Add Tag No Tags, Be the first to tag this record!

Description
Summary:	Aim . To compare cardioprotective effects of two renal denervation (RD) techniques: main renal artery or its branches after bifurcation in patients with resistant hypertension (RH). Materials and methods . This randomized double-blind clinical (ClinicalTrials. gov. identifier: NCT02667912) study with a follow-up of 12,3±1,6 months included 55 patients with RH, which was divided into 2 groups: group 1 (n=27) — main renal artery denervation; group 2 — RD of branches. Mean age of patients was 57,3±9,5 and 56,4±9,3 years, respectively. We assessed structural and functional cardiac characteristics using two-dimensional speckle-tracking echocardiography (STE). Results . Initially, the patients in the groups did not differ in terms of studied parameters and therapy. After RD in both groups, the levels of myocardial stress significantly decreased; 95% confidence interval: after main renal artery denervation — systolic [-4802; -2896], diastolic [-3264; -2032] dyne/cm 2 ; after RD of branches — [-6324; -5328] and [-4021; -2521] dyne/cm 2 , respectively (p=0,001 and 0,024, respectively). After main renal artery denervation, there was a decrease in the left ventricular (LV) wall thickness (interventricular septum [1,06; -0,62] and posterior wall [0,12; -0,62]) in comparison with RD of branches ([-0,68; -1,28] and [-0,68; -1,06], respectively). These differences were significant: p=0,023 and 0,021, respectively. After distal RD, decrease in the LV mass was observed more often by 21,2%, an increase in the LV mass was 2 times less frequent. Restoration of diastolic function was more common in patients after distal RD than main renal artery denervation (26% vs 13%, respectively). According to pilot analysis, STE parameters was also improved. Conclusion . Twelve months after distal RD, compared with the main renal artery denervation, the LV wall thickness, number of patients with LV hypertro -phy, and diastolic dysfunction decreased significantly greater. Two-dimensional STE revealed improvement of cardiac parameters. The results require further research.
ISSN:	1560-4071 2618-7620
DOI:	10.15829/1560-4071-2020-3994