CARDIOPROTECTIVE EFFECTS OF RENAL DENERVATION IN RESISTANT HYPERTENSION: EFFICIENCY PREDICTORS

Objective. To assess the impact of renal sympathetic denervation (RSD) in patients with resistant hypertension (RH) on the structural and functional changes (SFC) of the heart, and to determine predictors of the effectiveness of the procedure

Design and methods. Sixty patients (54.6 ± 9.5 years) with RH were included in the analysis. They signed an informed consent for both research and RSD. All of them received full-dose antihypertensive therapy (AHT) (4.1 drugs), including at least one diuretic. BP and heart rate (HR) measurement and cardiac diastolic function (DF) assessment by echocardiography were performed at baseline and after 24 weeks in all subjects. RSD was completed by endovascular radiofrequency ablation of renal arteries. AHT remained unchanged.

Results. There was a significant reduction of office BP, as well as a significant regression of myocardial mass in 36,7 % patients at 24 weeks after the procedure. DF was initially impaired in 58.6 %, and after the procedure it normalized in 31 %, and the diastolic dysfunction decreased in 14 % patients. Blood pressure, HR, ATH and left ventricular volume (LVV) were comparable in subgroups, and the dynamics of MM correlated only with the initial values of LV wall.

Conclusion. Significant positive changes of DF and the decrease of LV MM were registered 24 weeks after RSD. The initial values of LV wall thickness were the only predictor of MM regression.

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