title: Impact of Renal Sympathetic Denervation on Left Ventricular Structure and Function at 1-Year Follow-Up.
abstract: BACKGROUND
  Catheter-based sympathetic renal denervation (RDN) is a recent therapeutic option for patients with resistant hypertension. However, the impact of RDN in left ventricular (LV) mass and function is not completely established. Our aim was to evaluate the effects of RDN on LV structure and function (systolic and diastolic) in patients with resistant hypertension (HTN).
  
  
  RESULTS
  From a single centre prospective registry including 65 consecutive patients with resistant HTN submitted to RDN between July-2011 and April-2015, 31 patients with baseline and 1-year follow-up echocardiogram were included in this analysis. Mean age was 65 ± 7 years, 48% were males, 71% had type 2 diabetes. Most had hypertension lasting for more than 10 years (90%), and were being treated with a median number of 6 anti-hypertensive drugs, including 74% on spironolactone. At 1-year, there was a significant decrease both on office SBP (176 ± 24 to 149 ± 13 mmHg, p<0.001) and DBP (90 ± 14 to 79 ± 11 mmHg, p<0.001), and also in 24h ABPM SBP (150 ± 20 to 132 ± 14 mmhg, p<0.001) and DBP (83 ± 10 to 74 ± 9 mmHg, p<0.001). There was also a significant decrease in LV mass from 152 ± 32 to 136 ± 34 g/m(2) (p<0.001), an increase in LV end diastolic volume (93 ± 18 to 111 ± 27 mL, p = 0.004), an increase in LV ejection fraction (65 ± 9 to 68 ± 9%, p = 0.001) and mitral valve E deceleration time (225 ± 49 to 247 ± 51 ms, p = 0.015) at 1-year follow up. There were no significant changes in left atrium volume index or in the distribution of patients among the different left ventricle geometric patterns and diastolic function subgroups.
  
  
  CONCLUSIONS
  In this single centre registry of patients with resistant hypertension, renal denervation was associated with significant reduction in both office and ABPM blood pressure and a significant decrease in left ventricle mass evaluated by transthoracic echocardiogram at 1 year follow-up.
authors.affiliation: Hospital de Santa Cruz, Lisbon, Portugal.|Hospital da Luz, Lisbon, Portugal.|CEDOC- Nova Medical School, Lisbon, Portugal.
authors.forename: Manuel
authors.initials: M
authors.lastname: de Sousa Almeida
authors.affiliation: Hospital de Santa Cruz, Lisbon, Portugal.|Hospital da Luz, Lisbon, Portugal.|CEDOC- Nova Medical School, Lisbon, Portugal.
authors.forename: Pedro
authors.initials: P
authors.lastname: de Araújo Gonçalves
authors.affiliation: Hospital de Santa Cruz, Lisbon, Portugal.|Hospital da Luz, Lisbon, Portugal.
authors.forename: Patricia
authors.initials: P
authors.lastname: Branco
authors.affiliation: Hospital de Santa Cruz, Lisbon, Portugal.
authors.forename: João
authors.initials: J
authors.lastname: Mesquita
authors.affiliation: Hospital de Santa Cruz, Lisbon, Portugal.
authors.forename: Maria Salomé
authors.initials: MS
authors.lastname: Carvalho
authors.affiliation: Hospital de Santa Cruz, Lisbon, Portugal.|Hospital da Luz, Lisbon, Portugal.|CEDOC- Nova Medical School, Lisbon, Portugal.
authors.forename: Helder
authors.initials: H
authors.lastname: Dores
authors.affiliation: Hospital de Santa Cruz, Lisbon, Portugal.
authors.forename: Henrique
authors.initials: H
authors.lastname: Silva Sousa
authors.affiliation: Hospital de Santa Cruz, Lisbon, Portugal.
authors.forename: Augusta
authors.initials: A
authors.lastname: Gaspar
authors.affiliation: Hospital de Santa Cruz, Lisbon, Portugal.
authors.forename: Eduarda
authors.initials: E
authors.lastname: Horta
authors.affiliation: CEDOC- Nova Medical School, Lisbon, Portugal.
authors.forename: Ana
authors.initials: A
authors.lastname: Aleixo
authors.affiliation: CEDOC- Nova Medical School, Lisbon, Portugal.
authors.forename: Nuno
authors.initials: N
authors.lastname: Neuparth
authors.affiliation: Hospital de Santa Cruz, Lisbon, Portugal.
authors.forename: Miguel
authors.initials: M
authors.lastname: Mendes
authors.affiliation: Hospital de Santa Cruz, Lisbon, Portugal.
authors.forename: Maria João
authors.initials: MJ
authors.lastname: Andrade
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D001795:Blood Pressure Determination / Q000379:methods; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods; D003924:Diabetes Mellitus, Type 2 / Q000503:physiopathology / Q000601:surgery; D003971:Diastole / Q000187:drug effects / Q000502:physiology; D005260:Female; D005500:Follow-Up Studies; D006352:Heart Ventricles / Q000187:drug effects / Q000503:physiopathology*; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000503:physiopathology; D007668:Kidney / Q000294:innervation* / Q000601:surgery*; D008297:Male; D011446:Prospective Studies; D013562:Sympathectomy / Q000379:methods; D013564:Sympathetic Nervous System / Q000601:surgery*; D013599:Systole / Q000187:drug effects / Q000502:physiology; D016277:Ventricular Function, Left / Q000187:drug effects / Q000502:physiology*
chemical_list: D000959:Antihypertensive Agents