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

Jpn J Radiol. 2019 Sep;37(9):642-650. doi: 10.1007/s11604-019-00854-y. Epub 2019 Jul 12.

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

MeSH terms

  • Diastole
  • Female
  • Follow-Up Studies
  • Heart / physiopathology*
  • Heart Ventricles / diagnostic imaging
  • Humans
  • Hypertension / complications*
  • Hypertrophy, Left Ventricular / complications*
  • Hypertrophy, Left Ventricular / diagnostic imaging
  • Hypertrophy, Left Ventricular / therapy
  • Kidney / innervation
  • Kidney / surgery*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Sympathectomy / methods*
  • Treatment Outcome