- Walking poster presentation
- Open Access
Assessment of wall-shear stress pre and post renal sympathetic nerve denervation in patients with resistant hypertension
© Doltra et al; licensee BioMed Central Ltd. 2015
- Published: 3 February 2015
- Renal Artery
- Wall Shear Stress
- Peak Velocity
- Hemodynamic Effect
- Resistant Hypertension
Renal denervation (RD) is a promising treatment for patients with resistant hypertension, with a good safety profile. Studies performed in animal models have demonstrated an increase in renal arteries' velocity and flow. The hemodynamic effects of RD on renal arteries in humans remain unknown. The aim of our study is to evaluate the hemodynamic effect of RD on renal arteries non-invasively, using magnetic resonance (MR) techniques.
17 patients (age 65 ± 7.5 years, 28% women) with resistant hypertension undergoing RD were included. A 3.0 Tesla MR study (Ingenia, Philips Healthcare, The Netherlands) was performed before RD and 6 months after, and flow measurements of both renal arteries were obtained using through-plane breath-hold phase-contrast MR imaging. Peak velocity and mean flow were calculated. In addition, in a subset of 10 patients wall shear stress of both renal arteries was calculated using computerized flow analysis.
Systolic blood pressure decreased significantly after RD (149 ± 17 (147) mmHg baseline vs. 142 ± 16 (139), p = 0.01). A significant increase in peak velocity (656.72 ± 178.86 (620) mm/s baseline vs. 767.53 ± 301.55 (704) mm/s at follow-up, p = 0.021), and mean flow (5.8 ± 2.84 (5.6) ml/s baseline vs. 7.1 ± 3.48 (6.3) ml/s at follow-up, p = 0.007) was observed at 6 months follow-up. The computerized flow analysis demonstrated a significant decrease in wall shear stress in comparison to baseline (1.87 ± 1.23 Pa baseline vs. 1.39 ± 0.78 Pa at follow-up, p = 0.029). The observed results were independent of blood pressure reduction with RD.
RD leads to an increase in renal arteries' peak velocity and flow, as well as a concomitant decrease in wall shear stress. These effects reflect the disruption of sympathetic stimuli to the renal arteries with RD, independent of blood pressure response.
A. Doltra was supported by a Research Grant from the European Society of Cardiology.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.