https://doi.org/10.1007/s00392-025-02625-4
1Herzzentrum Leipzig - Universität Leipzig Klinik für Innere Medizin/Kardiologie Leipzig, Deutschland
Background: Large arterial stiffness is associated with adverse clinical cardiovascular events, but yet difficult to modify it with current medical and lifestyle treatment options. Renal denervation (RDN) affecting sympathetic activity might have a positive influence on arterial stiffening but there is only little data supporting this hypothesis. We aimed to assess changes in large arterial stiffness after RDN in a predefined subanalysis of a single-arm cohort of patients undergoing ultrasound RDN (uRDN).
Methods: Magnetic-resonance imaging (MRI) based measures of stiffness were assessed before as well as 3 months after uRDN in patients with treatment-resistant hypertension. MRI was used to asssess descending aortic flow reversal (FR), total arterial compliance (TAC), aortic pulse wave velocity (aPWV) as well as ascending aortic distensibility (AAD).
Results: Of the 80 patients included into the inital study, MRI before as well as 3 months after uRDN were available for 66 patients. At 3 months, 24h systolic and diastolic BP values were reduced by 10.0/6.7±12.2/8.0 mmHg. Ascending (- 5.0±17.5%, p =0.03), but not descending aortic FR (- 0.3±4.0%, p =0.5) were reduced at follow up. APWV was reduced by 1.4±4.4 m/s (p = 0.02). AAD increased by 0.4±1.1 x 10-3 (p = 0.02), while total arterial compliance was unchanged at follow up.
Conclusions: In this single-center cohort, arterial stiffness was found to improve after uRDN. In the absence of „hard“ clinical outcome data on the efficacy of RDN, hypothetically might result in improved long-term outcome. These findings warrant confirmation in comparison with conventional treatment of arterial hypertension.