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. 2018 Jan 19;8(1):1172.
doi: 10.1038/s41598-017-18671-6.

Effects of Renal Denervation on Cardiac Structural and Functional Abnormalities in Patients with Resistant Hypertension or Diastolic Dysfunction

Shiying Wang  1 , Suxia Yang  1 , Xinxin Zhao  1 , Jun Shi  2
Affiliations

Effects of Renal Denervation on Cardiac Structural and Functional Abnormalities in Patients with Resistant Hypertension or Diastolic Dysfunction

Shiying Wang et al. Sci Rep. .

Abstract

The aim of the present study is to systematically evaluate the impact of RDN on cardiac structure and function in patients with resistant hypertension (RH) or diastolic dysfunction. We retrieved Pubmed, Embase and Cocharane Library databases, from inception to April 1st, 2016. Studies reporting left ventricular mass (LVMI) or left ventricular (LV) diastolic function (reflected by the ratio of mitral inflow velocity to annular relaxation velocity [E/e']) responses to RDN were included. Two randomized controlled trials (RCTs), 3 controlled studies and 11 uncontrolled studies were finally identified. In observational studies, there was a reduction in LVMI, E/e' and N-terminal pro B-type natriuretic peptide (BNP) at 6 months, compared with pre-RDN values. LV ejection fraction (LVEF) elevated at 6 months following RDN. In RCTs, however, no significant change in LVMI, E/e', BNP, left atrial volume index or LVEF was observed at 12 months, compared with pharmaceutical therapy. In summary, both LV hypertrophy and cardiac function improved at 6 months after RDN. Nonetheless, current evidence failed to show that RDN was superior to intensive (optimal) drug therapy in improving cardiac remodeling and function.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Figure 1
Figure 1
Flow chart of literature search.
Figure 2
Figure 2
Forest plot of RDN changing LVMI in observational studies, stratified by follow up duration and imaging.
Figure 3
Figure 3
Forest plot of RDN changing LAVI (A) and E/e’ (B) at 12 months in randomized controlled trials.
Figure 4
Figure 4
Forest plot of RDN changing LVDD in observational studies, stratified by follow up duration and imaging.
Figure 5
Figure 5
Forest plot of RDN changing E/e’ in observational studies, stratified by follow up duration.
Figure 6
Figure 6
Forest plot of RDN changing EF in observational studies, stratified by follow up duration.
Figure 7
Figure 7
Meta-regression analysis showing the relationship between changes in (A) LVMI, (B) LVDD, (C) E/e’, (D) LVEF and systolic BP lowering.
See this image and copyright information in PMC

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