PROGNOSTIC SCALE OF RENAL DENERVATION EFFICACY

• Published in: Journal of hypertension Vol. 37 Suppl 1; pp. e281 - e282
• Main Authors: Plashchinskaya, L, Mrochek, A, Goncharik, D, Chasnoits, A, Barsukevich, V, Savchenko, A, Persidskikh, Y, Rebeko, E, Lazareva, I
• Format: Journal Article
• Language: English
• Published: Copyright Wolters Kluwer Health, Inc. All rights reserved 01-07-2019
• ISSN: 0263-6352; 1473-5598
• DOI: 10.1097/01.hjh.0000573592.81390.1d

OBJECTIVE:In the last few years, renal denervation (RDN) has become a treatment option for patients with resistant hypertension (RH). Based on preclinical and clinical studies, the initial enthusiasm has given way to a more cautious attitude as a consequence of the negative results in the largest randomized and blind controlled study (SYMPLICITY HTN-3). Patient selection is therefore the focus of current research to identify the population that could benefit most from RDN. The purpose of our study was to develop a prognostic scale of RDN in the treatment of patients (pts) with RH.
DESIGN AND METHOD:Pts with RH (n = 98) were included in the study. All pts underwent RDN. Procedure was performed at the renal arteries (RA) by an experienced electrophysiologist using specialized electrode Symplicitycapacity of 8 - 10 W at 55 ° C, 4 - 10 points for each RA, for 2 minutes per point. The gender, age, office systolic blood pressure (SBP) at baseline, body mass index (BMI), diabetes, 24 h ambulatory SBP at baseline were assessed. Regression with Optimal Scaling (CATREG) was performed using SPSS 25.
RESULTS:The degree of lowering 24 h SBP 12 months after the RDN closely correlated with baseline 24 h SBP, BMI and age (p < 0.05). Their threshold values were determinedbaseline 24 h SBP - >153.3 mmHg (sensitivity 75.68%, specificity 83.87%), AUC = 0.84 [0.73; 0.92], p < 0.0001, age < 55 years (sensitivity 73%, specificity 45.2%), BMI >30.4 (sensitivity 83.8%, specificity 41.9%). Prognostic scale of renal denervation efficacy was created using a regression model with optimal scaling. The optimal threshold value of the sum points baseline 24 h SBP, BMI and age >25 points (sensitivity 75.68%, specificity 83.87%) was associated with the RDN efficacy.
CONCLUSIONS:Thus, a prognostic scale of renal denervation efficacy is based on an assessment of baseline 24 h SBP, age and BMI. Our findings might improve patient selection for RDN and increase the efficacy of the procedure.