Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20251, Hamburg, Germany.
Institute of Radiology and Interventional Therapy, Vivantes Auguste-Viktoria-Klinikum, Berlin, Germany.
Jpn J Radiol. 2019 Sep;37(9):642-650. doi: 10.1007/s11604-019-00854-y. Epub 2019 Jul 12.
To investigate the effects of renal denervation (RDN) on left ventricular (LV) mass, myocardial strain and diastolic function in patients with treatment-resistant arterial hypertension by cardiac magnet resonance imaging on a 12-month follow-up.
Sixteen patients (38% female) were examined before and 12 months after RDN. LV morphology and strain were analyzed. Diastolic function was determined by early (EPFR) and atrial peak filling rates (APFR) derived from differential volume-time-curve analysis. Clinical visits included 24-h ambulant blood pressure monitoring (ABPM).
Twelve months after RDN LV mass decreased from 80 ± 21 g/m to 74 ± 20 g/m (P < 0.05). Global radial (35 ± 12% vs. 41 ± 10%, P < 0.05) and longitudinal strain improved (- 15 ± 4% vs. - 17 ± 3%, P < 0.05). Global circumferential strain (- 16 ± 5% vs. - 18 ± 4%, P = 0.12) remained unchanged. The parameter of diastolic LV function PFRR (EPFR/APFR) improved following RDN (0.9 ± 0.4 vs. 1.1 ± 0.5, P < 0.05). Individual changes of LV mass were associated with an increase of EPFR (r = - 0.54, P < 0.05) and a reduction of APFR by trend (r = 0.45, P = 0.08). Systolic ABPM showed a decrease by trend (152 mmHg vs. 148 mmHg, P = 0.08).
After RDN we observed a reduction of LV mass, improvement of global strain and diastolic function.
通过心脏磁共振成像在 12 个月的随访中，研究肾去神经支配（RDN）对治疗抵抗性动脉高血压患者左心室（LV）质量、心肌应变和舒张功能的影响。
16 例患者（38%为女性）在 RDN 前和 12 个月后接受检查。分析 LV 形态和应变。舒张功能通过差速容积时间曲线分析确定早期（EPFR）和心房峰值充盈率（APFR）。临床就诊包括 24 小时动态血压监测（ABPM）。
RDN 后 12 个月，LV 质量从 80±21g/m 降至 74±20g/m（P<0.05）。整体径向应变（35±12%比 41±10%，P<0.05）和纵向应变改善（-15±4%比-17±3%，P<0.05）。整体环向应变（-16±5%比-18±4%，P=0.12）保持不变。舒张期 LV 功能参数 PFRR（EPFR/APFR）在 RDN 后改善（0.9±0.4 比 1.1±0.5，P<0.05）。LV 质量的个体变化与 EPFR 的增加相关（r=-0.54，P<0.05），APFR 呈趋势性降低（r=0.45，P=0.08）。收缩压 ABPM 呈趋势性降低（152mmHg 比 148mmHg，P=0.08）。
RDN 后，我们观察到 LV 质量减少、整体应变和舒张功能改善。
