title: Long-term effects of multielectrode renal denervation on cardiac adaptations in resistant hypertensive patients with left ventricular hypertrophy.
abstract: Left ventricular (LV) hypertrophy and diastolic dysfunction predict long-term cardiovascular events. We evaluated whether multielectrode renal denervation (RDN) can provide beneficial cardiac adaptations in patients with resistant hypertension and LV hypertrophy long term at 24 months. Seventeen patients with true drug-resistant hypertension (age: 57±9 years, 11 men, body mass index: 33.79±5.49 kg m-2, office blood pressure (BP): 183±20/97±18 mm Hg and ambulatory BP: 152±16/86±15 mm Hg receiving 4.5 anti-hypertensive drugs per day) and LV hypertrophy underwent multielectrode RDN (EnligHTNTM, St Jude Medical). At baseline, LV mass index averaged 141.1±16.8 g m-2(58.4±7.8 g m-2.7) and mitral lateral E/E' 14.7±6.2. At 6, 12 and 24 months after RDN, the LV mass/body surface area (LV mass per height2.7) reduced significantly by 9.1% (8.8%), 11.3% (10.5%) and 15.5% (14.1%), respectively; and the mitral lateral E/E' reduced significantly by 14.0%, 15.3% and 29.7%, respectively. At 24 months after RDN, majority (70.6%) of the patients showed regression of LV hypertrophy of at least one level; the proportion of patients with concentric LV hypertrophy had dropped by 47.1% from baseline; and the proportion of patients with office systolic BP level of ⩾160 mm Hg had dropped by 76.5% from baseline. No statistically significant association was observed between the changes in office BP and the changes in LV mass index or diastolic function. In patients with drug-resistant hypertension and LV hypertrophy, multielectrode RDN can contribute to significant and sustained improvements of diastolic dysfunction and attenuation of LV mass indices long term at 24 months.
authors.affiliation: First Cardiology Clinic, University of Athens, Hippokration Hospital, Athens, Greece.
authors.forename: C
authors.initials: C
authors.lastname: Tsioufis
authors.affiliation: Veterans Affairs Medical Center, Cardiology Department and Georgetown Medical Centers, Washington, DC, USA.
authors.forename: V
authors.initials: V
authors.lastname: Papademetriou
authors.affiliation: First Cardiology Clinic, University of Athens, Hippokration Hospital, Athens, Greece.
authors.forename: K
authors.initials: K
authors.lastname: Dimitriadis
authors.affiliation: First Cardiology Clinic, University of Athens, Hippokration Hospital, Athens, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Kasiakogias
authors.affiliation: First Cardiology Clinic, University of Athens, Hippokration Hospital, Athens, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Kordalis
authors.affiliation: First Cardiology Clinic, University of Athens, Hippokration Hospital, Athens, Greece.
authors.forename: E
authors.initials: E
authors.lastname: Andrikou
authors.affiliation: First Cardiology Clinic, University of Athens, Hippokration Hospital, Athens, Greece.
authors.forename: A
authors.initials: A
authors.lastname: Milkas
authors.affiliation: First Cardiology Clinic, University of Athens, Hippokration Hospital, Athens, Greece.
authors.forename: I
authors.initials: I
authors.lastname: Liatakis
authors.affiliation: St Jude Medical, Inc., Irvine, CA, USA.
authors.forename: E O-Y
authors.initials: EO
authors.lastname: Lau
authors.affiliation: First Cardiology Clinic, University of Athens, Hippokration Hospital, Athens, Greece.
authors.forename: D
authors.initials: D
authors.lastname: Tousoulis
mesh_terms: D000222:Adaptation, Physiological; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001794:Blood Pressure / Q000187:drug effects; D017115:Catheter Ablation / Q000295:instrumentation*; D004351:Drug Resistance; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D007668:Kidney / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function; D012077:Renal Artery / Q000294:innervation*; D013562:Sympathectomy / Q000009:adverse effects / Q000295:instrumentation* / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome; D018487:Ventricular Dysfunction, Left / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D016277:Ventricular Function, Left; D020257:Ventricular Remodeling
chemical_list: D000959:Antihypertensive Agents
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