title: Proof of concept study: Improvement of echocardiographic parameters after renal sympathetic denervation in CKD refractory hypertensive patients.
abstract: OBJECTIVE
  Evaluation of the effectiveness of the renal sympathetic denervation (RSD) in reducing lesions of target organs such as the heart and kidneys, in resistant hypertensive CKD patients.
  
  
  RESULTS
  Forty-five patients were included and treated with an ablation catheter with open irrigated tip. RSD was performed by a single operator following the standard technique. Patients included with CKD were on stages 2 (n=22), 3 (n=16), and 4 (n=7). Data were obtained at baseline and monthly until the 6th month of follow-up. Twenty-six out of the 45 patients had LVH and nineteen did not present LVH. The LV mass index decreased from 123.70±38.44g/m(2) at baseline to 106.50±31.88g/m(2) at the 6th month after RSD, P<0.0001. The end-diastolic left ventricular internal dimension (LVIDd) reduced from 53.02±6.59mm at baseline to 51.11±5.85mm 6months post procedure, P<0.0001. The left ventricular end-diastolic posterior wall thickness (PWTd) showed a reduction from 10.58±1.39mm at baseline to 9.82±1.15mm at the 6th month of follow-up, P<0.0001. The end-diastolic interventricular septum thickness (IVSTd) also decreased from 10.58±1.39mm at baseline to 9.82±1.15mm 6months post procedure, P<0.0001. The left ventricular ejection fraction (LVEF) improved from 58.90±10.48% at baseline to 62.24±10.50% at the 6th month of follow-up, P<0.0001. When the ∆ between baseline and the 6th month post RSD in LVH patients and non LVH patients were compared to the same parameters no significant difference was found.
  
  
  CONCLUSIONS
  The RSD seemed to be feasible, effective, and safe resulting in an improvement of echocardiographic parameters in LVH and non LVH CKD refractory hypertensive patients.
authors.affiliation: Renal Division, Department of Medicine, Universidade Federal Fluminense, Niterói, RJ, Brazil; Hospital Regional Darcy Vargas, Rio Bonito, RJ, Brazil.
authors.forename: Márcio Galindo
authors.initials: MG
authors.lastname: Kiuchi
authors.affiliation: Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, SP, Brazil.
authors.forename: Decio
authors.initials: D
authors.lastname: Mion
authors.affiliation: Renal Division, Department of Medicine, Universidade Federal Fluminense, Niterói, RJ, Brazil.
authors.forename: Miguel Luis
authors.initials: ML
authors.lastname: Graciano
authors.affiliation: Renal Division, Department of Medicine, Universidade Federal Fluminense, Niterói, RJ, Brazil.
authors.forename: Maria Angela Magalhães
authors.initials: MA
authors.lastname: de Queiroz Carreira
authors.affiliation: Hospital Regional Darcy Vargas, Rio Bonito, RJ, Brazil.
authors.forename: Tetsuaki
authors.initials: T
authors.lastname: Kiuchi
authors.affiliation: Department of Cardiology, Shanghai First People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Fellowship of European Heart Rhythm Association/European Society of Cardiology, Department of Cardiology, Elisabethinen University Teaching Hospital Linz, Linz, Austria.
authors.forename: Shaojie
authors.initials: S
authors.lastname: Chen
authors.affiliation: Renal Division, Department of Medicine, Universidade Federal Fluminense, Niterói, RJ, Brazil. Electronic address: jocerl@huap.uff.br.
authors.forename: Jocemir Ronaldo
authors.initials: JR
authors.lastname: Lugon
mesh_terms: D000328:Adult; D000368:Aged; D017115:Catheter Ablation / Q000379:methods*; D004452:Echocardiography; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000601:surgery*; D017379:Hypertrophy, Left Ventricular / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D051436:Renal Insufficiency, Chronic / Q000473:pathology* / Q000601:surgery; D013562:Sympathectomy / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Blood pressure; Chronic kidney disease; Echocardiographic parameters; Hypertension; Left ventricular hypertrophy; Renal sympathetic denervation