Abstract 13547: Improved Blood Pressure and MRI Indices of Cardiovascular and Renal Function With Renal Denervation (EnligHTN-MRI Study)
Introduction: Renal denervation is proven to effectively lower blood pressure with sustained reduction over time. A recent study has shown improved cardiac function following renal denervation using echocardiographic parameters. Few animal studies have shown improved renal perfusion post-renal denervation. Our study aims to show sustained blood pressure reduction with improvement in cardiovascular and renal perfusion and function in humans post-renal denervation using MRI indices.
Hypothesis: We assessed the hypotheses that a reduction in blood pressure following renal denervation results in reduced myocardial mass and fibrosis; alongwith improved myocardial and renal perfusion and function.
Methods: This is a prospective, single-arm, single centre study looking at short (6 months) and long-term (24 months) changes in 20 patients post-renal denervation with regards to cardiovascular structure and function and renal blood flow using MRI indices.
Results: Data for 8 patients shows that mean baseline office BP of 180/98mmHg reduced by 29/14mmHg to 151/84mmHg at 3 months. Mean baseline average ambulatory BP of 144/78mmHg reduced by 3/3mmHg to 141/75mmHg at 3 months. Mean baseline left ventricular stroke volume of 90.2ml increased by 4.6ml to 94.8ml at 1 month and right ventricular stroke volume improved by 8.3ml from 80.6ml to 88.9ml. Mean baseline left ventricular ejection fraction of 67.3% improved by 1.2 to 68.5% at 1 month and right ventricular ejection fraction improved by 0.6 from 66.3% to 66.9%. Mean myocardial mass reduced by 1.4g at 1 month from 139.6g to 138.2g. Mean baseline right renal artery maximum flow velocity of 61.2cm/s increased by 10.4cm/s to 71.6cm/s at 1 month and left renal artery maximum flow velocity increased by 13.2cm/s from 56.7cm/s at baseline to 69.9cm/s at 1 month. Mean baseline right renal blood flow of 5.52ml increased by 1.34ml to 6.86ml at 1 month and baseline left renal blood flow of 5.47ml increased by 1.07ml to 6.54ml at 1 month. Renal function was stable in all patients with marginal improvement in few.
Conclusions: In conclusion renal denervation shows significant reduction in blood pressure alongwith improved cardiovascular structure and function and increased renal blood flow with no deterioration of renal function.
- © 2013 by American Heart Association, Inc.