Universität zu Köln

Brandt, Mathias C., Reda, Sara, Mahfoud, Felix, Lenski, Matthias, Boehm, Michael and Hoppe, Uta C. (2012). Effects of Renal Sympathetic Denervation on Arterial Stiffness and Central Hemodynamics in Patients With Resistant Hypertension. J. Am. Coll. Cardiol., 60 (19). S. 1956 - 1966. NEW YORK: ELSEVIER SCIENCE INC. ISSN 1558-3597

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Abstract

Objectives This study investigated the effect of catheter-based renal sympathetic denervation (RD) on central hemodynamics in patients with resistant hypertension. Background High central blood pressure (BP) increases cardiovascular events and mortality independently of peripheral BP. The effect of RD on central BP is unclear. Methods A total of 110 patients underwent bilateral RD. Radial artery applanation tonometry and pulse wave analysis were used to derive central aortic pressure and hemodynamic indices at baseline and 1, 3, and 6 months after ablation. Ten patients with resistant hypertension not undergoing RD served as controls. Results RD significantly reduced mean central aortic BP from 167/92 mm Hg to 149/88 mm Hg, 147/85 mm Hg, and 141/85 mm Hg at 1, 3, and 6 months (p < 0.001), respectively. Aortic pulse pressure decreased from 76.2 +/- 23.3 mm Hg to 61.5 +/- 17.5 mm Hg, 62.7 +/- 18.1 mm Hg, and 54.5 +/- 15.7 mm Hg 1, 3, and 6 months after RD (p < 0.001), respectively. Six months after RD aortic augmentation and augmentation index were significantly reduced by -11 mm Hg (p < 0.001) and -5.3% (p < 0.001), respectively. Carotid to femoral pulse wave velocity showed a significant reduction from 11.6 +/- 3.2 m/s to 9.6 +/- 3.1 m/s at 6 months (p < 0.001). Consistently, ejection duration and aortic systolic pressure load were significantly diminished, indicating improvement of cardiac work load by RD. No significant changes were obtained in control patients. Conclusions Besides the known effect of RD on brachial blood pressure, the study showed for the first time that this novel approach significantly improves arterial stiffness and central hemodynamics, which might have important prognostic implications in patients with resistant hypertension at high cardiovascular risk. (J Am Coll Cardiol 2012;60:1956-65) (C) 2012 by the American College of Cardiology Foundation

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Brandt, Mathias C. UNSPECIFIED UNSPECIFIED UNSPECIFIED Reda, Sara UNSPECIFIED UNSPECIFIED UNSPECIFIED Mahfoud, Felix UNSPECIFIED UNSPECIFIED UNSPECIFIED Lenski, Matthias UNSPECIFIED UNSPECIFIED UNSPECIFIED Boehm, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Hoppe, Uta C. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-479106
DOI:	10.1016/j.jacc.2012.08.959
Journal or Publication Title:	J. Am. Coll. Cardiol.
Volume:	60
Number:	19
Page Range:	S. 1956 - 1966
Date:	2012
Publisher:	ELSEVIER SCIENCE INC
Place of Publication:	NEW YORK
ISSN:	1558-3597
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PULSE-WAVE VELOCITY; LEFT-VENTRICULAR HYPERTROPHY; BLOOD-PRESSURE REDUCTION; CENTRAL AORTIC PRESSURES; CARDIOVASCULAR EVENTS; AUGMENTATION INDEX; HEART-DISEASE; ALL-CAUSE; MORTALITY; REFLECTIONS Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/47910