title: 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.
abstract: OBJECTIVE
  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.
  
  
  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/m(1.7) vs. 43.0 ± 12.6 g/m(1.7), P < 0.001) without changes in the control group (41.9 ± 10.8 g/m(1.7) vs. 42.0 ± 9.7 g/m(1.7), 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.
authors.affiliation: Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany felix.mahfoud@uks.eu.
authors.forename: Felix
authors.initials: F
authors.lastname: Mahfoud
authors.affiliation: Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany Klinik für Innere Medizin/Kardiologie, Deutsches Herzzentrum Berlin, Berlin, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Urban
authors.affiliation: Klinik für Innere Medizin/Kardiologie, Deutsches Herzzentrum Berlin, Berlin, Germany.
authors.forename: Desiree
authors.initials: D
authors.lastname: Teller
authors.affiliation: Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany.
authors.forename: Dominik
authors.initials: D
authors.lastname: Linz
authors.affiliation: Klinik für Innere Medizin/Kardiologie, Deutsches Herzzentrum Berlin, Berlin, Germany.
authors.forename: Philipp
authors.initials: P
authors.lastname: Stawowy
authors.affiliation: Klinik für Innere Medizin/Kardiologie, Deutsches Herzzentrum Berlin, Berlin, Germany.
authors.forename: Jan-Hendrik
authors.initials: JH
authors.lastname: Hassel
authors.affiliation: Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany.
authors.forename: Peter
authors.initials: P
authors.lastname: Fries
authors.affiliation: Klinik für Innere Medizin/Kardiologie, Deutsches Herzzentrum Berlin, Berlin, Germany.
authors.forename: Stephan
authors.initials: S
authors.lastname: Dreysse
authors.affiliation: Klinik für Innere Medizin/Kardiologie, Deutsches Herzzentrum Berlin, Berlin, Germany.
authors.forename: Ernst
authors.initials: E
authors.lastname: Wellnhofer
authors.affiliation: Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany.
authors.forename: Günther
authors.initials: G
authors.lastname: Schneider
authors.affiliation: Klinik für Diagnostische und Interventionelle Radiologie, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany.
authors.forename: Arno
authors.initials: A
authors.lastname: Buecker
authors.affiliation: Klinik für Innere Medizin/Kardiologie, Deutsches Herzzentrum Berlin, Berlin, Germany.
authors.forename: Christopher
authors.initials: C
authors.lastname: Schneeweis
authors.affiliation: Klinik für Innere Medizin/Kardiologie, Deutsches Herzzentrum Berlin, Berlin, Germany.
authors.forename: Adelina
authors.initials: A
authors.lastname: Doltra
authors.affiliation: Baker IDI Heart & Diabetes Institute, Melbourne, Australia.
authors.forename: Markus P
authors.initials: MP
authors.lastname: Schlaich
authors.affiliation: Baker IDI Heart & Diabetes Institute, Melbourne, Australia.
authors.forename: Murray D
authors.initials: MD
authors.lastname: Esler
authors.affiliation: Klinik für Innere Medizin/Kardiologie, Deutsches Herzzentrum Berlin, Berlin, Germany.
authors.forename: Eckart
authors.initials: E
authors.lastname: Fleck
authors.affiliation: Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Böhm
authors.affiliation: Klinik für Innere Medizin/Kardiologie, Deutsches Herzzentrum Berlin, Berlin, Germany.
authors.forename: Sebastian
authors.initials: S
authors.lastname: Kelle
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology; D017115:Catheter Ablation; D004351:Drug Resistance; D005260:Female; D006325:Heart Atria; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology / Q000601:surgery*; D017379:Hypertrophy, Left Ventricular / Q000209:etiology / Q000503:physiopathology; D018810:Magnetic Resonance Angiography; D008297:Male; D013312:Stress, Physiological / Q000502:physiology; D013562:Sympathectomy / Q000379:methods*; D016277:Ventricular Function, Left / Q000502:physiology
chemical_list: D000959:Antihypertensive Agents
keywords: Cardiovascular magnetic resonance; Circumferential strain; Left ventricular hypertrophy; Renal nerve ablation; Resistant hypertension