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2017 ; 10
(ä): 243-249
Nephropedia Template TP
gab.com Text
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Twit Text #
English Wikipedia
Renal sympathetic denervation increases renal blood volume per cardiac cycle: a
serial magnetic resonance imaging study in resistant hypertension
#MMPMID28919800
Delacroix S
; Chokka RG
; Nelson AJ
; Wong DT
; Sidharta S
; Pederson SM
; Rajwani A
; Nimmo J
; Teo KS
; Worthley SG
Int J Nephrol Renovasc Dis
2017[]; 10
(ä): 243-249
PMID28919800
show ga
AIM: Preclinical studies have demonstrated improvements in renal blood flow after
renal sympathetic denervation (RSDN); however, such effects are yet to be
confirmed in patients with resistant hypertension. Herein, we assessed the
effects of RSDN on renal artery blood flow and diameter at multiple time points
post-RSDN. METHODS AND RESULTS: Patients (n=11) with systolic blood pressures
?160 mmHg despite taking three or more antihypertensive medications at maximum
tolerated dose were recruited into this single-center, prospective, non-blinded
study. Magnetic resonance imaging indices included renal blood flow and renal
artery diameters at baseline, 1 month and 6 months. In addition to significant
decreases in blood pressures (p<0.0001), total volume of blood flow per cardiac
cycle increased by 20% from 6.9±2 mL at baseline to 8.4±2 mL (p=0.003) at 1 month
and to 8.0±2 mL (p=0.04) 6 months post-procedure, with no changes in the renal
blood flow. There was a significant decrease in renal artery diameters from 7±2
mm at baseline to 6±1 mm (p=0.03) at 1 month post-procedure. This decrease was
associated with increases in maximum velocity of blood flow from 73±20 cm/s at
baseline to 78±19 cm/s at 1 month post-procedure. Notably, both parameters
reverted to 7±2 mm and 72±18 cm/s, respectively, 6 months after procedure.
CONCLUSION: RSDN improves renal physiology as evidenced by significant
improvements in total volume of blood flow per cardiac cycle. Additionally, for
the first time, we identified a transient decrease in renal artery diameters
immediately after procedure potentially caused by edema and inflammation that
reverted to baseline values 6 months post-procedure.