Abstract
Purpose . To study the regression of left ventricular hypertrophy (LVH) in men and women with resistant hypertension (RH) after renal denervation (RDN). Material and Methods . A total of 84 patients (50% men) with RH were enrolled in the study after signing informed consent. Renal denervation was performed in all patients. Initially and at 6 and 12 months after treatment, patients underwent careful examination. These analyses included office blood pressure (BP) measurement, transthoracic echocardiography (TTE) study with assessments of the left ventricular (LV) wall thickness and LV mass (LVM), and cardiac magnetic resonance (CMR) imaging. Results. Groups of men and women were comparable in regard to office BP, age, number of administered antihypertensive drugs, and the number of radiofrequency energy applications for RDN. The LVM in the male group was significantly higher than in women due to anatomy differences. According to echocardiography data, the rate of LVH was insignificantly higher in women: 90% in women versus 76% in men, χ 2 = 0.079. In the presence of a significant and comparable BP reduction, significant regression in the values interventricular wall thickness (by 4.4%, р =0.039) and LVM (by 9.5%, р =0.044) was found in men one year after RND according to data of echocardiography. According to CMR according to CMR, LVM decreased by 11.9% at six months ( р =0.039) and by 22.9% at 12 months ( р =0.026) after RND. However, no significant changes in LVM were found in women. The extent of LVM regression did not depend on the antihypertensive effect of RDN in either group. Conclusion. The frequency of LVH was insignificantly higher in women than in men: 90% in women versus 76% in men. One year after RDN, LVH significantly regressed in men, but not in women, and did not depend on degree of BP reduction.
Highlights
Informed consent was obtained from all patients
The study was approved by the Ethics Committee of Cardiology Research Institute of Tomsk NRMC
Отдельного внимания наряду с возможностями фармакотерапии заслуживает метод ренальной денервации (РДН), позволяющий, по отдельным данным, реализовать стойкий кардиопротективный эффект лечения [5, 6]
Summary
Исследование выполнено в соответствии с национальными и международными стандартами проведения клинических исследований (Хельсинкская Декларация Всемирной медицинской ассоциации) при одобрении Комитета по биомедицинской этике НИИ кардиологии Томского НИМЦ. Консультативный отбор производился из популяции пациентов, направленных для обследования в НИИ кардиологии (Томск) с учетом резистентности АГ к амбулаторно подобранной многокомпонентной терапии в максимально переносимых терапевтических дозировках. Включение пациентов в исследование осуществлялось после анализа результатов расширенного клинико-инструментального обследования в соответствии c рекомендациями по исключению вторичных форм АГ и псевдорезистентности, а также подписания информированного согласия на участие. Критерии включения: – мужчины и женщины 18–80 лет; – артериальное давление (АД) ≥ 160/100 мм рт. Сравнительная характеристика мужчин и женщин представлена в таблице 1. Итого годовой этап обследования завершили 69 пациентов (2 умерли, из них один от инсульта; 13 не вышли на контакт/отказались от дальнейшего наблюдения). Сравнительная клиническая характеристика мужчин и женщин, включенных в исследование Table 1.
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
