[PP.23.04] ADIPOKINES LEVELS AND SYMPATHETIC ACTIVITY AFTER RENAL DENERVATION: RELATION TO VASCULAR REACTIVITY AND STIFFNESS

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Abstract

Objective:

Renal denervation results in reduction of local and overall noradrenaline spillover, which may lead to alteration of different parameters associated with excess sympathetic activity. Obesity is closely linked to increased sympathetic tone and we assessed the change of circulating adipokines levels and their relation to vascular reactivity and stiffness after renal denervation in patients with true resistant hypertension (RHTN) during one year follow-up.

Design and method:

Renal denervation (Ardian, Medtronic) was performed according to standard protocol in 20 patients (8 men and 12 women, mean age 56,6 ± 10,0 years) with confirmed true resistant hypertension. All patients were examined before and 12 months after the procedure, including: anthropometric parameters, office blood pressure (BP), 24-hours urine excretion of metanephrines, applanation tonometry (SphygmoCor, Artcor Medical) with calculation of central systolic and diastolic pressure, augmentation index *75HR (AI), pulse wave velocity (PWV), reactive hyperemia index (RHI) by EndoPat (Itamar Medicals). Serum adipokine levels (adiponectin, leptin, resistin, visfatin, adipsin) were determined by Bio Plex Pro Human assays. During 1-year follow-up the patients were on conventional, but stable diet, physical activity and antihypertensive treatment.

Results:

There were no significant changes in anthropometric parameters one year after procedure: BMI 30.65 ± 4.99 vs 30.20 ± 5.11, weight 86.36 ± 20.33 vs 85.95 ± 19.56 and waist 98.41 ± 9.18 vs 99.54 ± 10.20, p = 0.34–0.63. Adipokines levels were also stable, with the only exception being adiponectin, which decreased significantly one year after procedure: 36.06 ± 21.20/15.55 ± 9.07 μg/ml (p = 0.010). Metanephrine secretion decreased significantly 12-months after renal denervation: 0.803 ± 0.100/0.379 ± 0.074 (p = 0.000).

Results:

Vascular stiffness improved at the end of follow-up with decrease of PWV from 10.09 ± 1.88 to 9.25 ± 2.04 (p = 0.034). While there was a negative trend in endothelial function with decrease of RHI from 2.14 ± 0.63 to 1.7 ± 0.38 (p = 0.011), but still within normal values.

Results:

We calculated differences between final and baseline parameters and revealed that the change of PWV was associated with decrease of adipsin level (r = 0.949, p = 0.05) and central systolic blood pressure (r = 0.397, p = 0.028).

Conclusions:

Renal denervation have a limited impact on obesity parameters. Decrease of arterial stiffness after procedure appears to be associated with change in adipsin and blood pressure levels.

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