Impact of renal sympathetic denervation on cardiac magnetic resonance-derived cardiac indices in hypertensive patients – a meta-analysis

Bazoukis, George, Thomopoulos, Costas, Tse, Gary, Vassiliou, Vassilios, Liu, Tong, Dimitriadis, Kyriakos, Tatakis, Fotios, Konstantinou, Konstantinos, Doumas, Michael and Tsioufis, Konstantinos (2021) Impact of renal sympathetic denervation on cardiac magnetic resonance-derived cardiac indices in hypertensive patients – a meta-analysis. Journal of Cardiology. ISSN 0914-5087

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Abstract

Background Renal sympathetic denervation (RDN) is a safe device-based option for the treatment of hypertension although current guidelines do not recommend its use in routine clinical practice. In this meta-analysis, we investigated the effects of RDN in cardiac magnetic resonance (CMR)-derived cardiac indices. Methods This meta-analysis was performed in accordance with the PRISMA statement. A comprehensive systematic search of MEDLINE database and Cochrane library through to January 2021 was performed. The inclusion criteria were studies that enrolled patients undergoing RDN in whom CMR data were provided for left ventricular end-diastolic volume indexed to body surface area (BSA) (LVEDVI), left ventricular end-systolic volume indexed (LVESVI), left ventricular mass indexed (LVMI), and left ventricular ejection fraction (LVEF) pre and post RDN. A random effects model was used for the analyses. Results Our search strategy revealed 9 studies that were finally included in the meta-analysis (n=300 patients, mean age: 60 years old, males: 59%). Compared to control group, RDN patients showed significantly lower values in the attained volumes (LVEDVI: -6.70 ml/m2, p=0.01; LVESVI: -3.63 ml/m2, p=0.006). Moreover, RDN group achieved a statistically significant higher attained LVEF (3.49%, p=0.01). A non-significant difference was found in the attained LVMI between RDN and control groups (-2.59 g/m2, p=0.39). Compared to pre-RDN values, RDN reduces significantly the LVMI, the LVEDVI, and the LVESVI while a non-significant change of LVEF was found. Conclusions In conclusion, the current study demonstrates the potential beneficial role of RDN in CMR-derived cardiac indices that reflect adverse remodeling. However, large, randomized studies are needed to elucidate the role of RDN in cardiac remodeling in hypertension, heart failure, and other clinical settings.

Item Type: Article
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: LivePure Connector
Date Deposited: 11 May 2021 00:14
Last Modified: 14 Jun 2021 00:11
URI: https://ueaeprints.uea.ac.uk/id/eprint/79972
DOI: 10.1016/j.jjcc.2021.05.002

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