EFFECT OF RENAL DENERVATION ON THE PLASMA ADIPONECTIN CONCENTRATION IN PATIENTS WITH RESISTANT HYPERTENSION

Abstract

Objective: Adiponectin is produced by white adipose tissue and has anti-diabetic, anti-atherosclerotic, anti-thrombotic, anti-inflammatory, and cardioprotective properties. In patients with arterial hypertension plasma concentration of adiponectin is lower than in healthy subjects. Renal denervation (RDN) i.e. percutaneous ablation of fibers from the sympathetic nervous system located in the wall of the renal arteries by radio frequency waves, is a method of resistant arterial hypertension treatment. The aim of this single center, interventional, clinical study was to assess the effect of RDN on the plasma adiponectin concentration in patients with resistant arterial hypertension. Design and method: Twenty-six patients (12 women, 14 men) aged 54.0±7.8 years with resistant hypertension who underwent RDN using Simplicity catheters (Medtronic, Inc., Northridge, CA) were enrolled in the study. Plasma adiponectin concentration was determined using the Human Adiponectin ELISA Kit (Otsuka Pharmaceutical Co, Tokyo, Japan) before the RDN and 6 and 12 months after this procedure. Results: Blood pressure (BP) values before RDN and 6 and 12 months after RDN were as follow: systolic BP - 190.4±24.5, 160.8±14.5, 155.7±17.9 mmHg (p<0.001) and diastolic BP - 111.7±18.9, 88.9±8.3, 91.2±10.2 mmHg (p<0.001), respectively. Body mass index (BMI) before RDN, 6 and 12 months after RDN were 31.5±4.2, 30.5 ±4.4, 30.2±4.0 kg/m2, (p = 0.057), respectively. Plasma adiponectin concentration before the RDN and 6 and 12 months after RDN were 6.93±4.85, 7.94±3.97, 8.83±6.12 [μg/ml] (p = 0.007), respectively. In the follow up i.e. 6 and 12 months after RDN plasma adiponectin concentration increases significantly in responders (systolic BP decrease higher or equal 25 mmHg) (7.93±6.14, 8.87±4.68, 10.57±7.51 [μg/mL]; respectively]; p = 0.03, and did not change significantly in low-responders to RDN (systolic BP decrease < 25 mmHg) (5.76±2.45, 6.86±2.76, 6.81±3.19 [μg/mL]; respectively; p = 0.2). Conclusions: 1. Plasma adiponectin concentration increases significantly after successful RDN in patients with resistant arterial hypertension. 2. Higher plasma adiponectin concentration may participate - beyond blood pressure reduction - in the cardiovascular benefits related to successful RDN, however clinical consequences of our results need further investigations.