EFFECTS OF RENAL ARTERY DENERVATION ON LEFT VENTRICULAR DEFORMATION AND BLOOD FLOW VELOCITY IN THE DISTAL SEGMENT OF ANTERIOR DESCENDING CORONARY ARTERY AMONG PATIENTS WITH RESISTANT ARTERIAL HYPERTENSION

Aim. To assess the dynamics of left ventricular (LV) longitudinal deformation and blood flow velocity in the distal segment of anterior descending coronary artery (ADCA) among patients with resistant arterial hypertension (AH) 12 months after renal artery denervation.

Material and methods. In seven patients with resistant AH (mean age 52,00±6,59 years), bilateral renal artery denervation was performed. Five out of seven patients had concentric LV hypertrophy. The complex clinical and instrumental examination included the assessment of office and 24-hour blood pressure (BP) levels, echocardiography, speckle tracking imaging (2D strain), and transthoracic visualisation of the distal segment of ADCA.

Results. Twelve months after renal artery denervation, office BP levels decreased by 31/20 mm Hg. Mean 24-hour, mean daytime, and mean nighttime BP levels reduced by 15,58/14,62 mm Hg, 17,1/14,9 mm Hg, and by 21,1/14,47 mm Hg, respectively. There was an increase in global longitudinal LV deformation and local LV deformation (basal septal segment, basal and middle segments of

anterior and posterior walls, and middle and apical segments of lateral wall). The improvement in longitudinal systolic LV function was associated with reduced linear velocity of diastolic blood flow in the distal ADCA segment, without similar systolic changes.

Conclusion. Our results suggest that renal artery denervation is linked to improved LV function; therefore, this method could be widely recommended for the management of patients with resistant AH.

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