Effects of multielectrode renal denervation on cardiac and neurohumoral adaptations in resistant hypertension with cardiac hypertrophy: An EnligHTN I substudy

Costas Tsioufis, Vasilios Papademetriou, Kyriakos Dimitriadis, Dimitris Tsiachris, Costas Thomopoulos, Alexandros Kasiakogias, Athanasios Kordalis, Anna Kefala, Evagelia Koutra, Elizabeth Oi Yan Lau, Guido Grassi, Christodoulos Stefanadis

Research output: Contribution to journalArticle

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Abstract

Objective: This EnligHTN I nonrandomized substudy investigated the effect of multielectrode renal denervation (RDN) on cardiac and neurohumoral adaptations. Methods: Eighteen patients with true drug-resistant hypertension [age: 56 ± 10 years, 12 men, BMI: 33.6 ± 5.4 kg/m, office blood pressure (BP) by automatic device (Omron): 182 ± 19/97 ± 18 mmHg and ambulatory BP (Spacelabs): 153 ± 16/87 ± 15 mmHg receiving 4.5 antihypertensive drugs/day] and left ventricular hypertrophy underwent multielectrode RDN (EnligHTN system; St. Jude Medical), whereas 10 patients served as controls. Both groups were followed-up for 6 months. Results: Demographic data were homogenous between both patient groups. In addition to reduction of office (-42/-17 mmHg, P <0.001) and ambulatory (-19/-9 mmHg, P <0.001) BP, RDN contributed to attenuation of left ventricular mass index from 140.0 ± 17.0 g/m2 (57.9 ± 7.9 g/m2.7) to 126.7 ± 19.2 g/m2 (52.6 ± 8.4 g/m2.7) (P <0.01 for both) and left atrial diameter from 42.4 ± 4.3 to 40.6 ± 3.6 mm (P = 0.004) at 6 months. Up to 56% of the RDN-group patients achieved a target of less than 140/90 mmHg in the office BP; proportion of RDN-group patients with concentric left ventricular hypertrophy had decreased by 39%; mitral lateral E/E′ ratio decreased from 14.8 ± 6.1 to 12.0 ± 3.2 (P = 0.016); isovolumic relaxation time shortened from 109.8 ± 16.2 to 100.8 ± 17.1 ms (P = 0.003); and N-terminal pro B-type natriuretic peptide levels reduced from 84.9 ± 35.9 to 57.2 ± 38.8 pg/ml (P <0.001) significantly at 6 months post-RDN. Control patients exhibited no significant changes in all the above parameters (P > 0.05) at 6 months. Conclusion: Multielectrode RDN contributes to improvement of diastolic dysfunction, reduction of left ventricular mass and attenuation of NT-proBNP, suggesting additional cardiovascular benefits in drug-resistant hypertension associated with left ventricular hypertrophy.

Original languageEnglish
Pages (from-to)346-353
Number of pages8
JournalJournal of Hypertension
Volume33
Issue number2
DOIs
Publication statusPublished - Feb 13 2015

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Cardiomegaly
Denervation
Left Ventricular Hypertrophy
Hypertension
Kidney
Blood Pressure
Left Ventricular Dysfunction
Pharmaceutical Preparations
Antihypertensive Agents
Demography
Equipment and Supplies

Keywords

  • drug-resistant hypertension
  • left ventricular hypertrophy
  • left ventricular mass
  • neurohormonal activation
  • renal sympathetic denervation

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Effects of multielectrode renal denervation on cardiac and neurohumoral adaptations in resistant hypertension with cardiac hypertrophy : An EnligHTN I substudy. / Tsioufis, Costas; Papademetriou, Vasilios; Dimitriadis, Kyriakos; Tsiachris, Dimitris; Thomopoulos, Costas; Kasiakogias, Alexandros; Kordalis, Athanasios; Kefala, Anna; Koutra, Evagelia; Lau, Elizabeth Oi Yan; Grassi, Guido; Stefanadis, Christodoulos.

In: Journal of Hypertension, Vol. 33, No. 2, 13.02.2015, p. 346-353.

Research output: Contribution to journalArticle

Tsioufis, C, Papademetriou, V, Dimitriadis, K, Tsiachris, D, Thomopoulos, C, Kasiakogias, A, Kordalis, A, Kefala, A, Koutra, E, Lau, EOY, Grassi, G & Stefanadis, C 2015, 'Effects of multielectrode renal denervation on cardiac and neurohumoral adaptations in resistant hypertension with cardiac hypertrophy: An EnligHTN I substudy', Journal of Hypertension, vol. 33, no. 2, pp. 346-353. https://doi.org/10.1097/HJH.0000000000000408
Tsioufis, Costas ; Papademetriou, Vasilios ; Dimitriadis, Kyriakos ; Tsiachris, Dimitris ; Thomopoulos, Costas ; Kasiakogias, Alexandros ; Kordalis, Athanasios ; Kefala, Anna ; Koutra, Evagelia ; Lau, Elizabeth Oi Yan ; Grassi, Guido ; Stefanadis, Christodoulos. / Effects of multielectrode renal denervation on cardiac and neurohumoral adaptations in resistant hypertension with cardiac hypertrophy : An EnligHTN I substudy. In: Journal of Hypertension. 2015 ; Vol. 33, No. 2. pp. 346-353.
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abstract = "Objective: This EnligHTN I nonrandomized substudy investigated the effect of multielectrode renal denervation (RDN) on cardiac and neurohumoral adaptations. Methods: Eighteen patients with true drug-resistant hypertension [age: 56 ± 10 years, 12 men, BMI: 33.6 ± 5.4 kg/m, office blood pressure (BP) by automatic device (Omron): 182 ± 19/97 ± 18 mmHg and ambulatory BP (Spacelabs): 153 ± 16/87 ± 15 mmHg receiving 4.5 antihypertensive drugs/day] and left ventricular hypertrophy underwent multielectrode RDN (EnligHTN system; St. Jude Medical), whereas 10 patients served as controls. Both groups were followed-up for 6 months. Results: Demographic data were homogenous between both patient groups. In addition to reduction of office (-42/-17 mmHg, P <0.001) and ambulatory (-19/-9 mmHg, P <0.001) BP, RDN contributed to attenuation of left ventricular mass index from 140.0 ± 17.0 g/m2 (57.9 ± 7.9 g/m2.7) to 126.7 ± 19.2 g/m2 (52.6 ± 8.4 g/m2.7) (P <0.01 for both) and left atrial diameter from 42.4 ± 4.3 to 40.6 ± 3.6 mm (P = 0.004) at 6 months. Up to 56{\%} of the RDN-group patients achieved a target of less than 140/90 mmHg in the office BP; proportion of RDN-group patients with concentric left ventricular hypertrophy had decreased by 39{\%}; mitral lateral E/E′ ratio decreased from 14.8 ± 6.1 to 12.0 ± 3.2 (P = 0.016); isovolumic relaxation time shortened from 109.8 ± 16.2 to 100.8 ± 17.1 ms (P = 0.003); and N-terminal pro B-type natriuretic peptide levels reduced from 84.9 ± 35.9 to 57.2 ± 38.8 pg/ml (P <0.001) significantly at 6 months post-RDN. Control patients exhibited no significant changes in all the above parameters (P > 0.05) at 6 months. Conclusion: Multielectrode RDN contributes to improvement of diastolic dysfunction, reduction of left ventricular mass and attenuation of NT-proBNP, suggesting additional cardiovascular benefits in drug-resistant hypertension associated with left ventricular hypertrophy.",
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T1 - Effects of multielectrode renal denervation on cardiac and neurohumoral adaptations in resistant hypertension with cardiac hypertrophy

T2 - An EnligHTN I substudy

AU - Tsioufis, Costas

AU - Papademetriou, Vasilios

AU - Dimitriadis, Kyriakos

AU - Tsiachris, Dimitris

AU - Thomopoulos, Costas

AU - Kasiakogias, Alexandros

AU - Kordalis, Athanasios

AU - Kefala, Anna

AU - Koutra, Evagelia

AU - Lau, Elizabeth Oi Yan

AU - Grassi, Guido

AU - Stefanadis, Christodoulos

PY - 2015/2/13

Y1 - 2015/2/13

N2 - Objective: This EnligHTN I nonrandomized substudy investigated the effect of multielectrode renal denervation (RDN) on cardiac and neurohumoral adaptations. Methods: Eighteen patients with true drug-resistant hypertension [age: 56 ± 10 years, 12 men, BMI: 33.6 ± 5.4 kg/m, office blood pressure (BP) by automatic device (Omron): 182 ± 19/97 ± 18 mmHg and ambulatory BP (Spacelabs): 153 ± 16/87 ± 15 mmHg receiving 4.5 antihypertensive drugs/day] and left ventricular hypertrophy underwent multielectrode RDN (EnligHTN system; St. Jude Medical), whereas 10 patients served as controls. Both groups were followed-up for 6 months. Results: Demographic data were homogenous between both patient groups. In addition to reduction of office (-42/-17 mmHg, P <0.001) and ambulatory (-19/-9 mmHg, P <0.001) BP, RDN contributed to attenuation of left ventricular mass index from 140.0 ± 17.0 g/m2 (57.9 ± 7.9 g/m2.7) to 126.7 ± 19.2 g/m2 (52.6 ± 8.4 g/m2.7) (P <0.01 for both) and left atrial diameter from 42.4 ± 4.3 to 40.6 ± 3.6 mm (P = 0.004) at 6 months. Up to 56% of the RDN-group patients achieved a target of less than 140/90 mmHg in the office BP; proportion of RDN-group patients with concentric left ventricular hypertrophy had decreased by 39%; mitral lateral E/E′ ratio decreased from 14.8 ± 6.1 to 12.0 ± 3.2 (P = 0.016); isovolumic relaxation time shortened from 109.8 ± 16.2 to 100.8 ± 17.1 ms (P = 0.003); and N-terminal pro B-type natriuretic peptide levels reduced from 84.9 ± 35.9 to 57.2 ± 38.8 pg/ml (P <0.001) significantly at 6 months post-RDN. Control patients exhibited no significant changes in all the above parameters (P > 0.05) at 6 months. Conclusion: Multielectrode RDN contributes to improvement of diastolic dysfunction, reduction of left ventricular mass and attenuation of NT-proBNP, suggesting additional cardiovascular benefits in drug-resistant hypertension associated with left ventricular hypertrophy.

AB - Objective: This EnligHTN I nonrandomized substudy investigated the effect of multielectrode renal denervation (RDN) on cardiac and neurohumoral adaptations. Methods: Eighteen patients with true drug-resistant hypertension [age: 56 ± 10 years, 12 men, BMI: 33.6 ± 5.4 kg/m, office blood pressure (BP) by automatic device (Omron): 182 ± 19/97 ± 18 mmHg and ambulatory BP (Spacelabs): 153 ± 16/87 ± 15 mmHg receiving 4.5 antihypertensive drugs/day] and left ventricular hypertrophy underwent multielectrode RDN (EnligHTN system; St. Jude Medical), whereas 10 patients served as controls. Both groups were followed-up for 6 months. Results: Demographic data were homogenous between both patient groups. In addition to reduction of office (-42/-17 mmHg, P <0.001) and ambulatory (-19/-9 mmHg, P <0.001) BP, RDN contributed to attenuation of left ventricular mass index from 140.0 ± 17.0 g/m2 (57.9 ± 7.9 g/m2.7) to 126.7 ± 19.2 g/m2 (52.6 ± 8.4 g/m2.7) (P <0.01 for both) and left atrial diameter from 42.4 ± 4.3 to 40.6 ± 3.6 mm (P = 0.004) at 6 months. Up to 56% of the RDN-group patients achieved a target of less than 140/90 mmHg in the office BP; proportion of RDN-group patients with concentric left ventricular hypertrophy had decreased by 39%; mitral lateral E/E′ ratio decreased from 14.8 ± 6.1 to 12.0 ± 3.2 (P = 0.016); isovolumic relaxation time shortened from 109.8 ± 16.2 to 100.8 ± 17.1 ms (P = 0.003); and N-terminal pro B-type natriuretic peptide levels reduced from 84.9 ± 35.9 to 57.2 ± 38.8 pg/ml (P <0.001) significantly at 6 months post-RDN. Control patients exhibited no significant changes in all the above parameters (P > 0.05) at 6 months. Conclusion: Multielectrode RDN contributes to improvement of diastolic dysfunction, reduction of left ventricular mass and attenuation of NT-proBNP, suggesting additional cardiovascular benefits in drug-resistant hypertension associated with left ventricular hypertrophy.

KW - drug-resistant hypertension

KW - left ventricular hypertrophy

KW - left ventricular mass

KW - neurohormonal activation

KW - renal sympathetic denervation

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