Long-Term Effects of Renal Artery Denervation
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design
2.2. Inclusion Criteria
2.3. Exclusion Criteria
2.4. Data Collection
2.5. Renal Artery Sympathetic Denervation
2.6. Arterial Stiffness and Wave Reflection Measurements
2.7. Follow-Up
2.8. Statistical Analysis
3. Results
3.1. Study Population
3.2. Time Course of Change in Blood Pressure
3.3. Time Course of Change in Carotid-Femoral Pulse Wave Velocity (cfPWV)
4. Discussion
5. Conclusions
Limitations
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Variables | Values (Mean (SD) [Min, Max]) | |
---|---|---|
Age, years | 56.0 (7.76) [33.0, 72.0] | |
Sex | ||
Male | n = 34 (46.5%) | |
Female | n = 39 (53.5%) | |
Waist circumference, cm | 115.5 (10.7) [95, 129] | |
Height, cm | 168.6 (8.6) [150, 186] | |
Weight, kg | 97.6 (17.7) [60.0, 134] | |
BMI (kg/m2) | 34.3 (5.6) [22.1, 51.2] | |
Drug regimen | Before procedure | 48 months after procedure |
Number of antihypertensive drugs | 5.97 (1.1) [4–11] | 5.45 (2.2) [3–11] |
Total number of pills | 7.33 (2.44) [2–14] | 6.92 (3.37) [2–16] |
Prescribed drug classes | ||
ACE-I/ARB | 73 (100%) | 47 (95.9%) |
Diuretics | 67 (91.8%) | 39 (79.6%) |
Calcium channel blockers | 63 (86.3%) | 42 (85.7%) |
Beta blockers | 66 (90.4%) | 27 (55.1%) |
Mineral receptor antagonists | 48 (65.7%) | 43 (87.8%) |
Centrally acting agents | 57 (78.1%) | 24 (49.0%) |
Alpha blockers | 45 (61.6%) | 32 (65.3%) |
Oral antidiabetic drugs * | 29 (39.7%) | 18 (36,7%) |
Oral anticoagulants | 5 (6.8%) | 8 (16.3%) |
Antiplatelet drugs | 21 (28.7%) | 23 (46.9%) |
Statins | 32 (44.4%) | 24 (48%) |
Variable (Median IQR) | Before Procedure | After 3 months | After 6 months | After 12 months | After 24 months | After 48 months | p-Value | Effect Size |
---|---|---|---|---|---|---|---|---|
Office systolic BP | 180 (40.0) | 162.5 (26.2) | 151 (29.0) | 153 (32.0) | 169 (38.5) | 165 (34.0) | <0.001 | 0.17 |
Office diastolic BP | 110 (15.0) | 94.5 (16.2) | 89.5 (18.5) | 93.5 (17.0) | 95 (21.5) | 95 (16.5) | <0.001 | 0.12 |
Office heart rate | 68 (8.2) | 64 (10.0) | 69 (10.5) | 72 (15.0) | 63 (22.5) | 74 (14.8) | 0.052 | 0.03 |
Mean systolic BP | 158 (23.5) | 153 (31.0) | 146 (26.0) | 150 (25.0) | 140.5 (20.8) | 140 (26.5) | <0.001 | 0.07 |
Mean diastolic BP | 100 (14.2) | 92 (19.0) | 89 (13.0) | 92 (15.2) | 90.5 (14.8) | 86 (16.2) | 0.01 | 0.04 |
Mean heart rate | 71.5 (12.8) | 68 (11.0) | 67 (14.5) | 66 (11.0) | 65.5 (13.5) | 70 (11.5) | NS | 0.01 |
Daytime mean systolic BP | 160 (23.5) | 153 (28.0) | 150 (26.0) | 154 (27.8) | 145 (18.8) | 143 (22.8) | <0.001 | 0.08 |
Daytime mean diastolic BP | 104 (16.5) | 94 (18.0) | 94 (13.5) | 93 (18.0) | 92 (15.0) | 98 (14.8) | 0.001 | 0.05 |
Daytime mean heart rate | 75.0 (13.0) | 70.5 (11.2) | 71.0 (15.0) | 70.0 (12.5) | 70.0 (14.5) | 71.5 (14.5) | NS | 0.01 |
Night-time mean systolic BP | 154 (29.0) | 141 (25.0) | 131 (28.8) | 141 (27.0) | 130 (37.2) | 133 (40.2) | 0.014 | 0.05 |
Night-time mean diastolic BP | 91 (17.5) | 84 (19.0) | 82 (12.8) | 84 (15.2) | 81 (18.0) | 77 (17.0) | NS | 0.02 |
Night-time mean heart rate | 64.0 (11.8) | 62.0 (11.2) | 60.0 (9.8) | 60.0 (8.5) | 61.0 (14.8) | 61.5 (13.2) | NS | 0.01 |
Systolic BP dipping | 7.1 (13.0) | 5.5 (10.3) | 7.1 (10.3) | 7.5 (7.3) | 6.4 (11.6) | 8.6 (13.0) | NS | 0.00 |
Diastolic BP dipping | 10.2 (11.9) | 9.6 (12.4) | 11.9 (8.5) | 11.7 (9.7) | 8.4 (8.8) | 11.6 (11.9) | NS | 0.02 |
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Juknevičius, V.; Berūkštis, A.; Juknevičienė, R.; Jasiūnas, E.; Šerpytis, P.; Laucevičius, A. Long-Term Effects of Renal Artery Denervation. Medicina 2021, 57, 662. https://doi.org/10.3390/medicina57070662
Juknevičius V, Berūkštis A, Juknevičienė R, Jasiūnas E, Šerpytis P, Laucevičius A. Long-Term Effects of Renal Artery Denervation. Medicina. 2021; 57(7):662. https://doi.org/10.3390/medicina57070662
Chicago/Turabian StyleJuknevičius, Vytautas, Andrius Berūkštis, Renata Juknevičienė, Eugenijus Jasiūnas, Pranas Šerpytis, and Aleksandras Laucevičius. 2021. "Long-Term Effects of Renal Artery Denervation" Medicina 57, no. 7: 662. https://doi.org/10.3390/medicina57070662