Effects of renal denervation on vascular remodelling in patients with heart failure and preserved ejection fraction: A randomised control trial
File(s)Patel H RDT-PEF vascular.pdf (137.97 KB)
Published version
Author(s)
Type
Journal Article
Abstract
Objective:
To assess the effect of renal denervation (RDT) on micro- and macro-vascular function in patients with heart
failure with preserved ejection fraction (HFpEF).
Design:
A prospective, randomised, open-controlled trial with blinded end-point analysis.
Setting:
A single-centre London teaching hospital.
Participants:
Twenty-five patients with HFpEF who were recruited into the RDT-PEF trial.
Main outcome measures:
Macro-vascular: 24-h ambulatory pulse pressure, aorta distensibilty (from cardiac magnetic
resonance imaging (CMR), aorta pulse wave velocity (CMR), augmentation index (peripheral tonometry) and renal artery
blood flow indices (renal MR). Micro-vascular: endothelial function (peripheral tonometry) and urine microalbuminuria.
Results:
At baseline, 15 patients were normotensive, 9 were hypertensive and 1 was hypotensive. RDT did not lower
any of the blood pressure indices. Though there was evidence of abnormal vascular function at rest, RDT did not affect
these at 3 or 12 months follow-up.
Conclusions:
RDT did not improve markers of macro- and micro-vascular function.
To assess the effect of renal denervation (RDT) on micro- and macro-vascular function in patients with heart
failure with preserved ejection fraction (HFpEF).
Design:
A prospective, randomised, open-controlled trial with blinded end-point analysis.
Setting:
A single-centre London teaching hospital.
Participants:
Twenty-five patients with HFpEF who were recruited into the RDT-PEF trial.
Main outcome measures:
Macro-vascular: 24-h ambulatory pulse pressure, aorta distensibilty (from cardiac magnetic
resonance imaging (CMR), aorta pulse wave velocity (CMR), augmentation index (peripheral tonometry) and renal artery
blood flow indices (renal MR). Micro-vascular: endothelial function (peripheral tonometry) and urine microalbuminuria.
Results:
At baseline, 15 patients were normotensive, 9 were hypertensive and 1 was hypotensive. RDT did not lower
any of the blood pressure indices. Though there was evidence of abnormal vascular function at rest, RDT did not affect
these at 3 or 12 months follow-up.
Conclusions:
RDT did not improve markers of macro- and micro-vascular function.
Date Issued
2017-01-03
Date Acceptance
2017-01-03
Citation
JRSM Cardiovascular Disease, 2017, 6
ISSN
2048-0040
Publisher
SAGE Publications Ltd
Journal / Book Title
JRSM Cardiovascular Disease
Volume
6
Copyright Statement
© The Author(s) 2017. This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 3.0 License (http://www.creativecommons.org/licenses/by-nc/3.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page(https://us.sagepub.com/en-us/nam/open-access-at-sage).
Sponsor
British Heart Foundation
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000396861200001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Grant Number
FS/11/67/28954
Subjects
Science & Technology
Life Sciences & Biomedicine
Cardiac & Cardiovascular Systems
Cardiovascular System & Cardiology
Renal denervation
heart failure with preserved ejection fraction
vascular function
pulse wave velocity
endothelial function
ARTERIAL STIFFNESS
OLDER PATIENTS
SYMPATHETIC DENERVATION
BLIND TRIAL
DYSFUNCTION
DISTENSIBILITY
HEMODYNAMICS
HYPERTENSION
ASSOCIATION
PROGRESSION
Publication Status
Published