P63 Modification of Sympathetic Tone by Renal Artery Denervation Causes Early, Significant and Sustained Arterial De-Stiffening

Abstract

Objective

To examine whether Sympathetic Renal Denervation (RDN) might have an additive value for cardiovascular risk decline beyond lowering blood pressure.

Methods

73 selected patients with resistant hypertension had RDN performed. Arterial stiffness was measured, using applanation tonometry, before the procedure, 24 to 48 hours following the procedure and subsequently 1, 3 and 6 months after the RDN.

Results

Within 48 hours RDN significantly reduced carotid-femoral aortic pulse wave velocity (AoPWV) from 11.3 ± 2.7 to 10.3 ± 2.6 m/s (p = 0.001), the reduction was sustained at months 1, 3, and 6. Early changes of AoPWV value did not correlate with office systolic or diastolic BP (p = 0.45; p = 0.33). Furthermore, the higher the initial AoPWV value, the greater the reduction of AoPWV was observed after 6 months: Q1 8.4 ± 1, Δ 0.05 ± 1.6/Q2 10.1 ± 0.4, Δ 1.1 ± 1.4/Q3 12.2±0.8, Δ 1.8 ± 1.7/Q4 15.3 ± 1.7, Δ 2.8 ± 2.1, (p = 0.002).

Conclusion

A sustainable effect on AoPWV, observed in our study as early as within 24–48 hours following the procedure and up to 6 months, suggests an additional RDN effect on reducing arterial stiffness and cardiovascular risk. The de-stiffening effect was greater in patients with high initial AoPWV.