Márcio Galindo Kiuchi1, Decio Mion2, Miguel Luis Graciano3, Maria Angela Magalhães de Queiroz Carreira3, Tetsuaki Kiuchi4, Shaojie Chen5, Jocemir Ronaldo Lugon6. 1. Renal Division, Department of Medicine, Universidade Federal Fluminense, Niterói, RJ, Brazil; Hospital Regional Darcy Vargas, Rio Bonito, RJ, Brazil. 2. Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, SP, Brazil. 3. Renal Division, Department of Medicine, Universidade Federal Fluminense, Niterói, RJ, Brazil. 4. Hospital Regional Darcy Vargas, Rio Bonito, RJ, Brazil. 5. Department of Cardiology, Shanghai First People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Fellowship of European Heart Rhythm Association/European Society of Cardiology, Department of Cardiology, Elisabethinen University Teaching Hospital Linz, Linz, Austria. 6. Renal Division, Department of Medicine, Universidade Federal Fluminense, Niterói, RJ, Brazil. Electronic address: jocerl@huap.uff.br.
Abstract
AIM: Evaluation of the effectiveness of the renal sympathetic denervation (RSD) in reducing lesions of target organs such as the heart and kidneys, in resistant hypertensive CKD patients. METHODS AND RESULTS: Forty-five patients were included and treated with an ablation catheter with open irrigated tip. RSD was performed by a single operator following the standard technique. Patients included with CKD were on stages 2 (n=22), 3 (n=16), and 4 (n=7). Data were obtained at baseline and monthly until the 6th month of follow-up. Twenty-six out of the 45 patients had LVH and nineteen did not present LVH. The LV mass index decreased from 123.70±38.44g/m(2) at baseline to 106.50±31.88g/m(2) at the 6th month after RSD, P<0.0001. The end-diastolic left ventricular internal dimension (LVIDd) reduced from 53.02±6.59mm at baseline to 51.11±5.85mm 6months post procedure, P<0.0001. The left ventricular end-diastolic posterior wall thickness (PWTd) showed a reduction from 10.58±1.39mm at baseline to 9.82±1.15mm at the 6th month of follow-up, P<0.0001. The end-diastolic interventricular septum thickness (IVSTd) also decreased from 10.58±1.39mm at baseline to 9.82±1.15mm 6months post procedure, P<0.0001. The left ventricular ejection fraction (LVEF) improved from 58.90±10.48% at baseline to 62.24±10.50% at the 6th month of follow-up, P<0.0001. When the ∆ between baseline and the 6th month post RSD in LVH patients and non LVH patients were compared to the same parameters no significant difference was found. CONCLUSIONS: The RSD seemed to be feasible, effective, and safe resulting in an improvement of echocardiographic parameters in LVH and non LVH CKD refractory hypertensive patients.
AIM: Evaluation of the effectiveness of the renal sympathetic denervation (RSD) in reducing lesions of target organs such as the heart and kidneys, in resistant hypertensiveCKDpatients. METHODS AND RESULTS: Forty-five patients were included and treated with an ablation catheter with open irrigated tip. RSD was performed by a single operator following the standard technique. Patients included with CKD were on stages 2 (n=22), 3 (n=16), and 4 (n=7). Data were obtained at baseline and monthly until the 6th month of follow-up. Twenty-six out of the 45 patients had LVH and nineteen did not present LVH. The LV mass index decreased from 123.70±38.44g/m(2) at baseline to 106.50±31.88g/m(2) at the 6th month after RSD, P<0.0001. The end-diastolic left ventricular internal dimension (LVIDd) reduced from 53.02±6.59mm at baseline to 51.11±5.85mm 6months post procedure, P<0.0001. The left ventricular end-diastolic posterior wall thickness (PWTd) showed a reduction from 10.58±1.39mm at baseline to 9.82±1.15mm at the 6th month of follow-up, P<0.0001. The end-diastolic interventricular septum thickness (IVSTd) also decreased from 10.58±1.39mm at baseline to 9.82±1.15mm 6months post procedure, P<0.0001. The left ventricular ejection fraction (LVEF) improved from 58.90±10.48% at baseline to 62.24±10.50% at the 6th month of follow-up, P<0.0001. When the ∆ between baseline and the 6th month post RSD in LVH patients and non LVH patients were compared to the same parameters no significant difference was found. CONCLUSIONS: The RSD seemed to be feasible, effective, and safe resulting in an improvement of echocardiographic parameters in LVH and non LVH CKD refractory hypertensivepatients.
Authors: Márcio Galindo Kiuchi; Jan K Ho; Janis Marc Nolde; Leslie Marisol Lugo Gavidia; Revathy Carnagarin; Vance B Matthews; Markus P Schlaich Journal: Front Physiol Date: 2020-01-14 Impact factor: 4.566
Authors: Márcio G Kiuchi; Shaojie Chen; Gustavo R E Silva; Luis M R Paz; Tetsuaki Kiuchi; Ary G de Paula Filho; Gladyston L L Souto Journal: Kidney Res Clin Pract Date: 2016-09-08
Authors: Neil A Hoye; Luke C Wilson; Gerard T Wilkins; David L Jardine; Tracey L Putt; Ari Samaranayaka; John B W Schollum; Robert J Walker Journal: Kidney Int Rep Date: 2017-05-04