[PP.10.13] ARTERIAL STIFFNESS AND ENDOTHELIAL FUNCTION IN PATIENTS WITH RESISTANT HYPERTENSION AFTER RENAL DENERVATION.

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Abstract

Objective:

We study the effect of renal denervation (RDN) on arterial stiffness and arterial functional in patients with resistant hypertension 6 months after RDN.

Design and method:

We examined 21 patients, average 57 ± 10 years, before and 6 months after successful RDN. Initially mean blood pressure was 174 ± 12 mmHg. All patients continued take the original multicomponent antihypertensive therapy unchanged. Arterial stiffness was determined by volume sphygmograph (VaSera 1000) we assessed pulse wave velocity aortic (PWA) and cardio-ankle vascular index (CAVI); by applanation tonometry (SPhygmoCor) - carotid-femoral pulse wave velocity (PWVcf); by ultrasound method echo-TRACKING technology (Aloka Prosound α7) - stiffness index (B), modulus of elastic deformation (Ep), artery distensibility (AC). Endothelial function was evaluated by finger photoplethysmography during reactive hyperemia (Angioscan-01). We assessed the occlusion amplitude index for the determination of endothelial function in the microvasculature and the occlusion phase shift index for the determination of endothelial function in the arteries of muscular type. Six months after RDN 12 patients were classified as responders (mean systolic BP was reduced on 10 mmHg and more).

Results:

At baseline arterial stiffness was increased in 19 patients (90%) by PWVcf, in 13 (62%) by CAVI, PWA – 8 (38%), index B – 4 (19%), EP – 10 (48%), AC – 5 (24%). Baseline endothelial dysfunction was found in 17 patients (81%) by occlusion amplitude index, in 18 (85%) by occlusion phase shift index. 6 months after RDN in responders PWVcf decreased from 13,7 ± 3,6 to 12,5 ± 3,1 m/s (p < 0,01), CAVI from 7,08 ± 3,4 to 6,02 ± 3,8 (p < 0,05), AC increased from 0,71 ± 0,32 to 0,93 ± 0,5 mm2/Kpa (p < 0,05). Endothelial dysfunction had tendency to positive change: occlusion phase shift index increased from 1,28 ± 0,67 to 1,42 ± 0,32 (p = 0,07). All parameters of arterial stiffness and endothelial function had not positive changes in nonresponders.

Conclusions:

After 6 months of RDN we detected the improvement of some indicators of arterial stiffness and tendency to improve endothelial function in responders.

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