Dasheng Lu1,2, Kai Wang1, Qian Liu1, Shengchan Wang1, Qi Zhang1, Qijun Shan3. 1. Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300# Guangzhou Road, Nanjing, 210029, Jiangsu, China. 2. Department of Cardiology, The Second Affiliated Hospital of Wannan Medical College, Wuhu, Anhui, China. 3. Department of Cardiology, The First Affiliated Hospital of Nanjing Medical University, 300# Guangzhou Road, Nanjing, 210029, Jiangsu, China. qjshan@njmu.edu.cn.
Abstract
BACKGROUND: Renal denervation (RDN), a novel therapy for resistant hypertension, has been shown to have an effect on cardiac remodeling in several small studies. We aimed to pool currently available data to assess the effects of RDN on left ventricular hypertrophy (LVH) and left atrial (LA) enlargement. METHODS AND RESULTS: Two investigators independently searched PubMed, EMBASE and Cochrane Library Central Register of Controlled Trials database for studies reporting change in left ventricular mass index (LVMI) or LA size before and after RDN. Twelve publications met our pre-defined inclusion criteria. Echocardiographic data showed that RDN markedly reduced both LVMI [weighted mean difference (WMD) = -15.77 g/m(2); 95 % confidence interval (CI) -22.51 to -9.02 g/m(2)] and LA diameter [WMD = -2.48 mm; 95 % CI -4.12 to -0.83 mm] after 6 months. Data from cardiac magnetic resonance also showed a significant reduction in LVMI [WMD = -5.43 g/m(2), 95 % CI -10.01 to -0.35 g/m(2)) at 6 months. Changes in LVH and LA size at 12 months were more pronounced than those at 6 months. Meta-regression analysis failed to demonstrate a significant relationship between RDN-induced LVMI reduction and BP lowering at 6 months. CONCLUSIONS: RDN led to significant regressions of both LVH and LA enlargement at 6 months, which were sustained at least up to 12 months.
BACKGROUND: Renal denervation (RDN), a novel therapy for resistant hypertension, has been shown to have an effect on cardiac remodeling in several small studies. We aimed to pool currently available data to assess the effects of RDN on left ventricular hypertrophy (LVH) and left atrial (LA) enlargement. METHODS AND RESULTS: Two investigators independently searched PubMed, EMBASE and Cochrane Library Central Register of Controlled Trials database for studies reporting change in left ventricular mass index (LVMI) or LA size before and after RDN. Twelve publications met our pre-defined inclusion criteria. Echocardiographic data showed that RDN markedly reduced both LVMI [weighted mean difference (WMD) = -15.77 g/m(2); 95 % confidence interval (CI) -22.51 to -9.02 g/m(2)] and LA diameter [WMD = -2.48 mm; 95 % CI -4.12 to -0.83 mm] after 6 months. Data from cardiac magnetic resonance also showed a significant reduction in LVMI [WMD = -5.43 g/m(2), 95 % CI -10.01 to -0.35 g/m(2)) at 6 months. Changes in LVH and LA size at 12 months were more pronounced than those at 6 months. Meta-regression analysis failed to demonstrate a significant relationship between RDN-induced LVMI reduction and BP lowering at 6 months. CONCLUSIONS: RDN led to significant regressions of both LVH and LA enlargement at 6 months, which were sustained at least up to 12 months.
Entities:
Keywords:
Left atrial size; Left ventricular hypertrophy; Left ventricular mass; Renal denervation; Resistant hypertension
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