Predictors for success of renal denervation in patients with resistant arterial hypertension
Предикторы эффективности ренальной денервации у больных с резистентной артериальной гипертензией
Orekhov A.Yu. Karazhanova L.K. Chinybayeva A.A. Zhukusheva S.T. Konradi A.O.
2023All-Russian Public Organization Antihypertensive League
Arterial Hypertension (Russian Federation)
2023#29Issue 2175 - 185 pp.
Objective. Development of principles for personalized selection of patients for renal denervation (RD) based on the evaluation of procedural response predictors. Design and methods. In the period from 2016 to 2022, 91 patients with resistant arterial hypertension (RHTN) underwent a RD procedure using 2 types of catheters — monopolar and spiral. All patients were assessed for basic demographic, clinical, functional, and laboratory characteristics. The reassessment was carried out on the 7th day, then after 6 and 12 months. A predictive model for determining the probability of response to RD was constructed using the logistic regression method. Results. The final analysis included data from 91 RHTN patients, the mean age was 57,79 ± 9,5 years. At baseline, patients received 4,5 ± 1,4 antihypertensive drugs. Initial office systolic blood pressure (SBP) was 190 (interquartile range (IQR) 100; 140, 240) mm Hg, diastolic blood pressure (DBP) — 100 (IQR 60; 80, 140) mm Hg. Among the responders, a significant reduction in blood pressure (BP) was achieved, with maintenance of the antihypertensive effect during 1 year of follow-up (p < 0,001 for SBP and DBP). The multivariate regression analysis showed that the initial DPB (p < 0,001), the diameter of the right (p = 0,049) and left renal arteries (RA) (p = 0,038) were significant predictors. Based on these data, a prognostic model was developed (p < 0,001). Conclusions. Our results confirmed effectiveness and safety of RD. The stability of the clinical effect is important. However, there was a high variability in the degree of BP reduction after the procedure. The initial DBP, the diameter of the left and right RA, and the use of drugs that reduce the activity of the sympathetic nervous system can be used as possible predictors of response to RD.
renal arteries , renal denervation , resistant arterial hypertension , sympathetic nervous system
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Semey Medical University, Semey, Kazakhstan
Corporate Fund “University Medical Center”, Astana, Kazakhstan
Astana Medical University, Astana, Kazakhstan
Almazov National Medical Research Centre, St Petersburg, Russian Federation
Semey Medical University
Corporate Fund “University Medical Center”
Astana Medical University
Almazov National Medical Research Centre
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