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Effect of renal denervation procedure on left ventricular mass, myocardial strain and diastolic function by CMR on a 12-month follow-up

  • Enver TahirEmail author
  • Andreas Koops
  • Malte L. Warncke
  • Jitka Starekova
  • Johannes T. Neumann
  • Christoph Waldeyer
  • Maxim Avanesov
  • Gunnar K. Lund
  • Roland Fischer
  • Gerhard Adam
  • Stefan Blankenberg
  • Ulrich O. Wenzel
  • Fabian J. Brunner
Original Article
  • 7 Downloads

Abstract

Purpose

To investigate the effects of renal denervation (RDN) on left ventricular (LV) mass, myocardial strain and diastolic function in patients with treatment-resistant arterial hypertension by cardiac magnet resonance imaging on a 12-month follow-up.

Materials and methods

Sixteen patients (38% female) were examined before and 12 months after RDN. LV morphology and strain were analyzed. Diastolic function was determined by early (EPFR) and atrial peak filling rates (APFR) derived from differential volume–time-curve analysis. Clinical visits included 24-h ambulant blood pressure monitoring (ABPM).

Results

Twelve months after RDN LV mass decreased from 80 ± 21 g/m2 to 74 ± 20 g/m2 (P < 0.05). Global radial (35 ± 12% vs. 41 ± 10%, P < 0.05) and longitudinal strain improved (− 15 ± 4% vs. − 17 ± 3%, P < 0.05). Global circumferential strain (− 16 ± 5% vs. − 18 ± 4%, P = 0.12) remained unchanged. The parameter of diastolic LV function PFRR (EPFR/APFR) improved following RDN (0.9 ± 0.4 vs. 1.1 ± 0.5, P < 0.05). Individual changes of LV mass were associated with an increase of EPFR (r = − 0.54, P < 0.05) and a reduction of APFR by trend (r = 0.45, P = 0.08). Systolic ABPM showed a decrease by trend (152 mmHg vs. 148 mmHg, P = 0.08).

Conclusions

After RDN we observed a reduction of LV mass, improvement of global strain and diastolic function.

Keywords

Renal denervation Arterial hypertension Left ventricular hypertrophy Myocardial strain Diastolic heart failure 

Abbreviations

ABPM

Ambulant blood pressure monitoring

APFR

Atrial peak filling rate

BSA

Body surface area

BMI

Body mass index

CMR

Cardiac magnetic resonance

EF

Ejection fraction

EPFR

Early peak filling rate

FT-CMR

Feature-tracking cardiac magnetic resonance

LV

Left ventricle/left ventricular

LVH

Left ventricular hypertrophy

NT-proBNP

N-terminal pro-brain natriuretic peptide

PFRR

Peak filling rate ratio

RV

Right ventricle

Notes

Acknowledgements

We thank Christiane Brodersen for the technical assistance.

Compliance with ethical standards

Ethical statement

All procedures were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments.

Conflict of interest

The authors report no conflicts of interest.

Supplementary material

11604_2019_854_MOESM1_ESM.jpg (462 kb)
Supplemental Figure E1: Patient flowchart. (JPG 461 kb)
11604_2019_854_MOESM2_ESM.docx (36 kb)
Supplemental Table E1: Demographics and drug therapy of patients with a baseline CMR only (Group 1, N=30) compared to patients with baseline and 12-month follow-up CMR (Group 2, N=16). (DOCX 36 kb)
11604_2019_854_MOESM3_ESM.docx (34 kb)
Supplemental Table E2: Baseline comparison of blood pressure and laboratory parameters of patients with a baseline CMR only (Group 1, N=30) and patients with baseline and 12-month follow-up CMR (Group 2, N=16). (DOCX 34 kb)
11604_2019_854_MOESM4_ESM.docx (36 kb)
Supplemental Table E3: Baseline CMR analysis of patients with a baseline CMR only (Group 1, N=30) compared to patients with baseline and 12-month follow-up CMR (Group 2, N=16). (DOCX 35 kb)

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Copyright information

© Japan Radiological Society 2019

Authors and Affiliations

  • Enver Tahir
    • 1
    Email author
  • Andreas Koops
    • 1
    • 2
  • Malte L. Warncke
    • 1
  • Jitka Starekova
    • 1
  • Johannes T. Neumann
    • 3
    • 4
  • Christoph Waldeyer
    • 3
  • Maxim Avanesov
    • 1
  • Gunnar K. Lund
    • 1
  • Roland Fischer
    • 5
    • 6
  • Gerhard Adam
    • 1
  • Stefan Blankenberg
    • 3
    • 4
  • Ulrich O. Wenzel
    • 7
  • Fabian J. Brunner
    • 3
  1. 1.Department of Diagnostic and Interventional Radiology and Nuclear MedicineUniversity Medical Center Hamburg-EppendorfHamburgGermany
  2. 2.Institute of Radiology and Interventional TherapyVivantes Auguste-Viktoria-KlinikumBerlinGermany
  3. 3.Department of General and Interventional CardiologyUniversity Heart CenterHamburgGermany
  4. 4.German Center for Cardiovascular Research (DZHK)HamburgGermany
  5. 5.Department of Pediatric Hematology and OncologyUniversity Medical Center Hamburg-EppendorfHamburgGermany
  6. 6.UCSF Benioff Children’s Hospital OaklandOaklandUSA
  7. 7.Department of Internal Medicine, NephrologyUniversity Medical Center Hamburg-EppendorfHamburgGermany

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