OBJECTIVE: This EnligHTN I nonrandomized substudy investigated the effect of multielectrode renal denervation (RDN) on cardiac and neurohumoral adaptations. METHODS: Eighteen patients with true drug-resistant hypertension [age: 56 ± 10 years, 12 men, BMI: 33.6 ± 5.4 kg/m, office blood pressure (BP) by automatic device (Omron): 182 ± 19/97 ± 18 mmHg and ambulatory BP (Spacelabs): 153 ± 16/87 ± 15 mmHg receiving 4.5 antihypertensive drugs/day] and left ventricular hypertrophy underwent multielectrode RDN (EnligHTN system; St. Jude Medical), whereas 10 patients served as controls. Both groups were followed-up for 6 months. RESULTS: Demographic data were homogenous between both patient groups. In addition to reduction of office (-42/-17 mmHg, P < 0.001) and ambulatory (-19/-9 mmHg, P < 0.001) BP, RDN contributed to attenuation of left ventricular mass index from 140.0 ± 17.0 g/m (57.9 ± 7.9 g/m) to 126.7 ± 19.2 g/m (52.6 ± 8.4 g/m) (P < 0.01 for both) and left atrial diameter from 42.4 ± 4.3 to 40.6 ± 3.6 mm (P = 0.004) at 6 months. Up to 56% of the RDN-group patients achieved a target of less than 140/90 mmHg in the office BP; proportion of RDN-group patients with concentric left ventricular hypertrophy had decreased by 39%; mitral lateral E/E' ratio decreased from 14.8 ± 6.1 to 12.0 ± 3.2 (P = 0.016); isovolumic relaxation time shortened from 109.8 ± 16.2 to 100.8 ± 17.1 ms (P = 0.003); and N-terminal pro B-type natriuretic peptide levels reduced from 84.9 ± 35.9 to 57.2 ± 38.8 pg/ml (P < 0.001) significantly at 6 months post-RDN. Control patients exhibited no significant changes in all the above parameters (P > 0.05) at 6 months. CONCLUSION: Multielectrode RDN contributes to improvement of diastolic dysfunction, reduction of left ventricular mass and attenuation of NT-proBNP, suggesting additional cardiovascular benefits in drug-resistant hypertension associated with left ventricular hypertrophy.
OBJECTIVE: This EnligHTN I nonrandomized substudy investigated the effect of multielectrode renal denervation (RDN) on cardiac and neurohumoral adaptations. METHODS: Eighteen patients with true drug-resistant hypertension [age: 56 ± 10 years, 12 men, BMI: 33.6 ± 5.4 kg/m, office blood pressure (BP) by automatic device (Omron): 182 ± 19/97 ± 18 mmHg and ambulatory BP (Spacelabs): 153 ± 16/87 ± 15 mmHg receiving 4.5 antihypertensive drugs/day] and left ventricular hypertrophy underwent multielectrode RDN (EnligHTN system; St. Jude Medical), whereas 10 patients served as controls. Both groups were followed-up for 6 months. RESULTS: Demographic data were homogenous between both patient groups. In addition to reduction of office (-42/-17 mmHg, P < 0.001) and ambulatory (-19/-9 mmHg, P < 0.001) BP, RDN contributed to attenuation of left ventricular mass index from 140.0 ± 17.0 g/m (57.9 ± 7.9 g/m) to 126.7 ± 19.2 g/m (52.6 ± 8.4 g/m) (P < 0.01 for both) and left atrial diameter from 42.4 ± 4.3 to 40.6 ± 3.6 mm (P = 0.004) at 6 months. Up to 56% of the RDN-group patients achieved a target of less than 140/90 mmHg in the office BP; proportion of RDN-group patients with concentric left ventricular hypertrophy had decreased by 39%; mitral lateral E/E' ratio decreased from 14.8 ± 6.1 to 12.0 ± 3.2 (P = 0.016); isovolumic relaxation time shortened from 109.8 ± 16.2 to 100.8 ± 17.1 ms (P = 0.003); and N-terminal pro B-type natriuretic peptide levels reduced from 84.9 ± 35.9 to 57.2 ± 38.8 pg/ml (P < 0.001) significantly at 6 months post-RDN. Control patients exhibited no significant changes in all the above parameters (P > 0.05) at 6 months. CONCLUSION: Multielectrode RDN contributes to improvement of diastolic dysfunction, reduction of left ventricular mass and attenuation of NT-proBNP, suggesting additional cardiovascular benefits in drug-resistant hypertension associated with left ventricular hypertrophy.
Authors: C Tsioufis; V Papademetriou; K Dimitriadis; A Kasiakogias; A Kordalis; E Andrikou; A Milkas; I Liatakis; E O-Y Lau; D Tousoulis Journal: J Hum Hypertens Date: 2016-01-28 Impact factor: 3.012
Authors: Denielli da Silva Gonçalves Bos; Chris Happé; Ingrid Schalij; Wioletta Pijacka; Julian F R Paton; Christophe Guignabert; Ly Tu; Raphaël Thuillet; Harm-Jan Bogaard; Albert C van Rossum; Anton Vonk-Noordegraaf; Frances S de Man; M Louis Handoko Journal: JACC Basic Transl Sci Date: 2017-02-01
Authors: David E Kandzari; Felix Mahfoud; Michael A Weber; Raymond Townsend; Gianfranco Parati; Naomi D L Fisher; Melvin D Lobo; Michael Bloch; Michael Böhm; Andrew S P Sharp; Roland E Schmieder; Michel Azizi; Markus P Schlaich; Vasilios Papademetriou; Ajay J Kirtane; Joost Daemen; Atul Pathak; Christian Ukena; Philipp Lurz; Guido Grassi; Martin Myers; Aloke V Finn; Marie-Claude Morice; Roxana Mehran; Peter Jüni; Gregg W Stone; Mitchell W Krucoff; Paul K Whelton; Konstantinos Tsioufis; Donald E Cutlip; Ernest Spitzer Journal: Circulation Date: 2022-03-14 Impact factor: 29.690