title: Could careful patient selection for renal denervation warrant a positive effect on arterial stiffness and left ventricular mass reduction?
abstract: OBJECTIVE
  After the sequence of Symplicity HTN trials, the impact of the procedure on lowering blood pressure (BP) and cardiovascular risk is still debatable. We present initial results of the multimodal pilot study that aimed at carefully selecting proper patients and investigating the effects of RASD on cardiac morphology and central haemodynamic parameters in 15 patients with resistant arterial hypertension prior and 6 months after RASD.
  
  
  RESULTS
  The multimodal (applanation tonometry, echocardiography and cardiac magnetic resonance (CMR)) study findings have shown a significant BP decrease (190/112 ± 23/12 to 153/91 ± 18/11 mm Hg, P < 0.002), a decrease of the arterial markers (carotid-femoral pulse wave velocity decreased from 11.46 ± 2.92 m/s to 9.17 ± 2.28 m/s and the augmentation index decreased from 25.47 ± 10.55 to 21 ± 12.19, P < 0.006), a significant left ventricular mass index decrease by 10% both by echocardiography (140.83 ± 38.46 to 115.26 ± 25.37 g/m2, n = 14, P < 0.001) and CMR (108.32 ± 39.02 to 97.25 ± 30.06 g/m2, n = 15, P = 0.003). A significant decrease of CMR retrograde flow volume in the ascending aorta non-dependent on BP was also found.
  
  
  CONCLUSIONS
  Our study is characterised by strict and extensive patient selection criteria for renal artery sympathetic denervation (RASD), which seem to warrant a positive effect of the procedure on BP, arterial stiffness and left ventricular mass 6 months after RASD, although it should be confirmed in larger controlled trials.
authors.forename: Darius
authors.initials: D
authors.lastname: Palionis
authors.forename: Andrius
authors.initials: A
authors.lastname: Berukstis
authors.forename: Nerijus
authors.initials: N
authors.lastname: Misonis
authors.forename: Ligita
authors.initials: L
authors.lastname: Ryliskyte
authors.forename: Jelena
authors.initials: J
authors.lastname: Celutkiene
authors.forename: Diana
authors.initials: D
authors.lastname: Zakarkaite
authors.forename: Kamile
authors.initials: K
authors.lastname: Cerlinskaite
authors.forename: Nomeda
authors.initials: N
authors.lastname: Valeviciene
authors.forename: Algirdas
authors.initials: A
authors.lastname: Tamosiunas
authors.forename: Aleksandrus
authors.initials: A
authors.lastname: Laucevicius
mesh_terms: D001795:Blood Pressure Determination; D004452:Echocardiography / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000209:etiology / Q000517:prevention & control; D008097:Lithuania; D008297:Male; D008875:Middle Aged; D018579:Patient Selection; D010865:Pilot Projects; D011184:Postoperative Period; D063177:Pulse Wave Analysis; D012077:Renal Artery / Q000294:innervation*; D013562:Sympathectomy / Q000009:adverse effects / Q000379:methods; D059289:Vascular Stiffness
keywords: Hypertension; arterial stiffness; left ventricular mass; magnetic resonance imaging; renal artery denervation; resistant arterial hypertension