Abstract 18179: Catheter-Based Renal Denervation Reduces Left Ventricular Mass in Patients with Resistant Hypertension - Results from a Multicenter Study

Abstract

BACKGROUND: Left ventricular (LV) hypertrophy is a common finding in patients with resistant hypertension and is associated with increased sympathetic activity and high cardiovascular risk. Catheter-based renal denervation (RD) has been shown to reduce blood pressure (BP) and sympathetic tone. The present study aimed to investigate the effect of RD on left ventricular mass, assessed by cardiac magnetic resonance (CMR), in patients with resistant hypertension, defined as office systolic BP >160 mmHg and >150 mmHg for patients with type 2 diabetes.

METHODS: CMR was performed in 25 patients at baseline and 6 months after RD in a multicenter setting. Clinical data and CMR results were analyzed blinded at both times. Data were analyzed using the Wilcoxon-Mann-Whitney test. All continuous parameters are given as mean + one standard deviation (SD). For all tests, p<0.05 was considered statistically significant. All tests were two-sided.

RESULTS: Patients were middle aged (64±7 years), had poorly controlled BP (177/101 mmHg), and heavily medicated (mean: 5.2 antihypertensive drugs). RD significantly reduced systolic BP by -27.1/-10.7 mmHg (p<0.001) and LV mass by 6.1% (163.2±46.3 g at baseline vs. 153.5±40.0 g after 6 months, p=0.017). Ejection fraction remained constant (59.8±10.7% vs. 59.6±10.5% at 6 months; p=0.946). No significant changes between baseline and 6 months were evident for LV end-systolic volume (74.5 ± 40.2 ml vs. 74.4 ± 39.2 ml; p=0.264) and LV end-diastolic volume (178.9 ± 52.4 ml vs. 174.5 ± 55.7; p=0.231), respectively.

CONCLUSIONS: Catheter-based renal denervation significantly reduced left ventricular mass in patients with resistant hypertension, as diagnosed by CMR. This might have important prognostic implications in patients with resistant hypertension and high cardiovascular risk.Figure:Impact of renal denervation on left ventricular mass (LVM)