Effect of renal denervation on diastolic function in patients with resistant hypertension and type 2 diabetes mellitus

Author:

Manukyan M. A.1ORCID,Falkovskaya A. Yu.1ORCID,Pekarskiy S. E.1ORCID,Zyubanova I. V.1ORCID,Solonskaya E. I.1ORCID,Ryabova T. R.1ORCID,Vtorushina A. A.1ORCID,Khunkhinova S. A.1ORCID,Skomkina I. A.1ORCID,Yevtukh A. A.1ORCID,Mordovin V. F.1ORCID

Affiliation:

1. Cardiology Research Institute, Tomsk National Research Medical Center, Russian Academy of Sciences

Abstract

Aim: To assess the change in the left ventricular (LV) diastolic function (DF) in patients with resistant hypertension (RHTN) and type 2 diabetes mellitus (T2DM) during 6-month follow-up after renal denervation (RDN) according to echocardiography in conjunction with changes in hemodynamic parameters.Material and Methods. A single center prospective interventional study with renal denervation included 30 patients with RHTN and T2DM. All patients underwent measurement of office and 24-hour blood pressure (BP), echocardiography according to the standard method with an assessment of LV DF.Results. At 6 months after RDN, a significant antihypertensive effect was noted (p < 0.05), as well as an improvement in LV DF in the form of a decrease in E/e` by 1 c.u. was observed in 50% (15) patients. A significant decrease in the average E/e` was documented (–1.3 [95% CI –2.55; –0.08], р = 0.038). There were no changes in the indexed volumes of the left atrium (р = 0.940). The baseline values of E/e` had correlation with the level of mean pulse BP 24h (r = 0.51, р = 0.001) in the absence of significant relationships with other ABPM parameters. A decrease in systolic BP 24h by 3 mm Hg and an increase in nocturnal systolic BP fall by 1.6% were accompanied by a decrease in the average E/e` by 1 unit. According to the ROC-analysis, baseline level of nocturnal systolic BP fall 5.5% or less associated with a decrease in the E/e` ratio by more than 1 unit.Conclusion. Renal denervation in patients with RHTN and T2DM is accompanied by a favorable effect on LV diastolic function during 6-month follow-up, closely related to the hemodynamic effects of the procedure such as a decrease in systolic and pulse BP 24h, as well as improvement in the circadian rhythm of BP.

Publisher

Cardiology Research Institute

Subject

Cardiology and Cardiovascular Medicine,Public Health, Environmental and Occupational Health,Radiology, Nuclear Medicine and imaging,Medicine (miscellaneous),Internal Medicine

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