Favorable effects on arterial stiffness after renal sympathetic denervation for the treatment of resistant hypertension: a cardiovascular magnetic resonance study

Abstract

Favorable effects on arterial stiffness after renal sympathetic denervation for the treatment of resistant hypertension: a cardiovascular magnetic resonance study Tommy Arild Hammer,1 Knut Asbjørn Rise Langlo,2 Pål Erik Goa,1,3 Fadl Elmula M Fadl Elmula,4,5 Pavel Hoffmann,6 Knut Haakon Stensaeth1,7 1Department of Radiology and Nuclear Medicine, 2Department of Nephrology, St Olav’s University Hospital, Trondheim, Norway; 3Department of Physics, Norwegian University of Science and Technology, Trondheim, Norway; 4Institute of Cardiovascular and Renal Research, Department of Cardiology, Oslo University Hospital, Oslo, Norway; 5Faculty of Clinical Medicine, University of Oslo, Oslo, Norway; 6Department of Cardiology, Oslo University Hospital, Oslo, Norway; 7Institute of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway Aims: Renal sympathetic denervation (RDN) has recently been suggested to be a novel treatment strategy for patients with treatment-resistant hypertension. However, the latest randomized studies have provided conflicting results and the influence of RDN on arterial stiffness remains unclear. Therefore, this study aimed to detect the effects of RDN on arterial stiffness as measured with aortic pulse wave velocity (PWV) and distensibility in addition to cardiac function and T1 mapping at baseline and at 6-month follow-up.Methods: RDN was performed in a total of 16 patients with treatment-resistant hypertension, and the procedures were conducted at two university hospitals using two different RDN devices. All patients and age-matched controls underwent a comprehensive clinical examination and cardiac magnetic resonance protocols both at baseline and at a 6-month follow-up.Results: In the treatment group, the systolic blood pressure (SBP) was found to be decreased at the follow-up visit (office SBP; 173±24 compared to 164±25 mmHg [P= 0.033]), the 24-hour ambulatory SBP had decreased (163±25 compared to 153±20 mmHg [P=0.057]), the aortic PWV had decreased from 8.24±3.34 to 6.54±1.31 m/s (P=0.053), and the aortic distensibility had increased from 2.33±1.34 to 3.96±3.05 10−3 mmHg−1 (P=0.013). The changes in aortic PWV and distensibility were independent of the observed reductions in SBP.Conclusion: The arterial stiffness, as assessed with aortic PWV, and distensibility were improved at 6 months after RDN. This improvement was independent of the reduction in SBP. Keywords: renal denervation, cardiovascular MR, arterial stiffness