PS-C12-9: CARDIO ANKLE VASCULAR INDEX AS A PREDICTOR OF SUCCESSFUL RENAL DENERVATION AND IMPROVED BP VARIABILITY IN SUBJECTS WITH RESISTANT HYPERTENSION

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Objective: The aim of the study was to determine the clinical characteristics of patients with increased arterial stiffness (AS) undergoing renal sympathetic denervation (RSD) and to examine the role of cardio ankle vascular index (CAVI) measurement in predicting the outcome of RSD. Another task was to assess the effect on the indices of blood pressure variability. Design and method: Consecutive patients with resistant hypertension who underwent RSD workout at the University Hospital Saint Anna, Sofia, between January 2014 and December 2020 were included. CAVI was measured using the VaSera system (Fukuda Denshi Co, Japan). RSD was performed with the Symplicity Flex catheter (Medtronic, Minneapolis, MN, USA) according to a standardized protocol. Blood pressure variability was assessed by weighted 24 h BPV by ABPM. Results: The study included 62 patients with treatment resistant hypertension, after out of office blood pressure measurement and intensification of therapy, renal denervation was performed in 32 (51.6%). Patients with increased arterial stiffness, defined as CAVI >median of 8.3, were older, with a larger waist circumference and previous cardiovascular events. A longterm effect of the RSD, reported as a reduction in 24-hour systolic blood pressure above 10 mmHg at month 12, was found in 22 patients (68.8%). The median of the observed reduction of the 24 hour systolic blood pressure was 16 mmHg at 95% confidence interval 9.1 to 21 mmHg. Despite similar baseline out of office and office blood pressure and concomitant antihypertensive therapy, patients with lower arterial stiffness had a more significant blood pressure effect of renal denervation, a result that persisted within 12 months of follow up. More profound and significant drop of BP variability was also noticed in this group of patients. In contrast, the effect of the procedure was clinically insignificant among patients with baseline CAVI values above 8.3. Difference in office and out of office BP between the baseline values and those at month 12 after RSD in patients with low arterial stiffness. Conclusions: These findings hold the promise that AS might be used as a selection criterion for RSD, thereby improving outcome following RSD.