LAUSR

Objectives: We were comparing the structure and function of the heart after distal renal denervation (DRD) and conventional (CRD): in segmental branches of renal artery versus conventional main trunk therapy: 12 month study in patients with resistant hypertension (RH) and left ventricle (LV) heart failure with preserved ejection fraction. Methods: All participants of research have given the informed agreement. This was a double-blind, randomized prospective study (NCT01499810 - ClinicalTrials.gov) in 55 patients meeting criteria of RH. Patients were randomize either to endovascular CRD of the main renal arteria (1st g. n = 27) or to distal treatment applied in segmental branches after the bifurcation of the main renal arteria (2nd g. 2n = 28). Echocardiographic cut-off values adapted from the ASE/ESC guidelines. Parameters EF - ejection fraction, LVM - LV mass, myocardial stress (MS), IVRT - isovolumic relaxation time, and other parameters of the LV diastolic function were performed at baseline and 12 months follow-up. Results: Treatment consisted in combination therapy: patients were taking 4.1 groups of antihypertensive drugs. A significantly greater decreased parameters of the left ventricle: LVM (−4.9 ± 37.4 vs −36.3 ± 34.5 p < 0.05 g), and MS (−1784.0 ± 2294 vs −5133.6 ± 1556.2 p < 0.05 dynes / cm2) were performed at baseline and 12 months follow-up. Patients with minimal abnormalities in LV diastolic function responded to treatment most favorably after the procedure: normalization of diastolic function was found in 30% and 13% of patients with LV diastolic dysfunction degree 1 and 2, respectively Conclusion: DRD treatment compared with CRD reduced myocardial stress further, as well as a positive impact on the parameters of the left ventricle after 12 months in patients with RH.