Author + information
- Andrius Berukstis1,
- Nerijus Misonis1,
- Ligita Ryliskyte1,
- Rokas Navickas1,
- Kamile Cerlinskaite2 and
- Aleksandras Laucevicius1
Renal sympathetic denervation (RSD) has been reported to reduce blood pressure in patients with resistant arterial hypertension, although it takes time before noticeable changes after the procedure occur. There are several reports on late changes in arterial stiffness after RSD. We have investigated early and late changes in arterial stiffness after denervation searching for the markers of RSD effectiveness.
We have evaluated 20 patients with resistant arterial hypertension (age 56.2±7.4 years, 11 male, 9 female, mean 24-hour ambulatory blood pressure (BP) - 160/96±19/16 mm Hg, using 6.1±1.1 antihypertensive drugs), who underwent bilateral RSD. Arterial stiffness parameters were measured before the procedure, during the first 48 hours after RSD and, subsequently, after 1, 3 and 6 months.
During the first 48 hours after RSD, a significant reduction in peripheral BP from 182/107±28/19 to 163/95±17/11 mmHg (p=0.003), and mean arterial pressure (MAP) from 135±23 to 116±13 mmHg (p=0.0003) was observed. RSD significantly reduced carotid-femoral pulse wave velocity (PWV) during the first 48 hours from 11.2±2.9 to 9.7±2.1 m/s (p=0.0004) and carotid-radial PWV from 10.3±2.4 to 8.8±1.4 (p=0.008). Analysis of variance revealed the MAP independent improvement of PWV during 48 hours after RSD (r=-0.07, p=0.8). Furthermore, a substantial decrease in carotid-femoral PWV has been recorded at 1, 3 and 6 months, 9.5±2.3 (p<0.001), 9.41±2.78 (p=0.006) and 8.94±2.03 (p<0.001), respectively. In addition, reduction in carotid-radial PWV sustained at 1, 3 and 6 months, 9.24±1.33 (p=0.051), 8.99±1.65 (p=0.063) and 8.67±1.20 (p=0.007), respectively.
Changes in arterial stiffness occur early after RSD. During the first 48 hours after the procedure, a significant reduction of arterial stiffness parameters, which remained at 1, 3 and 6 months have been noted. RSD effects on PWV were independent from blood pressure changes.