THE EFFECTS OF TRANSCATHETER RENAL DENERVATION ON BLOOD PRESSURE AND BRAIN STRUCTURAL CHANGES IN RESISTANT HYPERTENSION

Objective. To study the changes of 24-hour blood pressure parameters and brain structure at follow-up after transcatheter renal denervation in resistant hypertension.

Design and methods. We enrolled patients with verified resistant hypertension undergoing an intervention that included 4–8 applications of radiofrequency discharge in both renal arteries using a standard catheter5 F under the controlled temperature regimen (60 С0, 8 Watt, 2-minute application). The efficiency of the intervention was assessed by the office and 24-hour blood pressure decrease within 6 months after intervention. All subjects underwent magnetic resonance tomography («Magnetom-OPEN», «Siemens AG», Germany).

Results. By the time of statistical analysis 45 subjects underwent renal denervation, there was not a single case of renal artery damage. At six-month follow-up a significant reduction of office blood pressure (-34,8/-17,2 mmHg; p < 0,00001/0,00001), and mean 24-hour blood pressure (-11,1/-7,1 mmHg; p < 0,001/0,001) was found. No increase of encephalopathy signs by magnetic resonance tomography was found. At the same time there was a reduction of the linear size of lateral ventricles of the brain, subarachnoid space, III ventricle of the brain, liquor volume in the lateral ventricles of the brain.

Conclusions. Renal denervation is a safe method resulting in effective blood pressure reduction in resistant hypertension. It is associated with the positive changes of encephalopathy and liquor dynamics according to the magnetic resonance tomography. 

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