Heart failure & cardiomyopathies
Modulation of Pulsatile Left Ventricular Afterload by Renal Denervation in Heart Failure With Preserved Ejection Fraction
Authors' conclusion
HFpEF is characterized by heightened aortic stiffness and unfavorable pulsatile left ventricular load. These abnormalities are partly normalized after renal denervation.
Study context
- Population
- Patients undergoing renal denervation for hypertension
- Participants
- 30 vs 30
- Exposure
- Heart failure with preserved ejection fraction (HFpEF) vs hypertensive controls without HF; before vs 3 months after renal denervation
- HFpEFn = 30
- Controln = 30reference
- Outcome
- Pulsatile LV afterload (LV vascular load parameters)
- Follow-up
- 3 months
Methodological detailssingle-centre
- Single-centre
Main finding
As reported in the abstract
LV vascular load, HFpEF vs control (baseline)
HFpEF vs ControlMean difference, mL/mm Hg (95% CI)
Total arterial compliance
−0.41(−0.72 to −0.10)
HFpEF vs ControlDifference, mHg·s/mL (95% CI)
Zc
0.02(0.01–0.04)
HFpEF vs ControlDifference (95% CI)
Backward wave transit time normalized to ejection time
−3.5(−6.5% to −0.5%)
Reflection coefficient
7.3(2.8%–11.9%)
Observational data: associations, not effects.
Further findings
| Outcome | Change (mm Hg) (CI) | |
|---|---|---|
| BP after renal denervation (overall) · 3 monthsAfter renal denervationvs BeforeDaytime SBP | −9.2 (−12.2 to −6.2) | |
| BP after renal denervation (overall) · 3 monthsAfter renal denervationvs BeforeDaytime DBP | −5.9 (−7.6 to −4.1) | |
| BP after renal denervation (overall) · 3 monthsAfter renal denervationvs BeforeBP variability | −2.0 (−3.0 to −0.9) | |
| −15−10−505Difference, mm Hg (linear scale) |
| Outcome | Change (mL/mm Hg) (CI) | |
|---|---|---|
| LV vascular load after renal denervation (HFpEF) · 3 monthsAfter renal denervationvs BeforeTotal arterial compliance | 0.42 (0.17–0.67) | |
| −0.500.51Difference, mL/mm Hg (linear scale) |
| Outcome | Change (CI) | |
|---|---|---|
| LV vascular load after renal denervation (HFpEF) · 3 monthsAfter renal denervationvs BeforeBackward transit time normalized to ejection time | 1.7 (0.4%–3.0%) | |
| LV vascular load after renal denervation (HFpEF) · 3 monthsAfter renal denervationvs BeforeReflection coefficient | −2.6 (−5.0% to −0.3%) | |
| −6−4−2024Difference (linear scale) |
| Outcome | Change (mm Hg·s/mL) (CI) | |
|---|---|---|
| LV vascular load after renal denervation (HFpEF) · 3 monthsAfter renal denervationvs BeforeZc | −0.01 (−0.02 to −0.01) | |
| −0.03−0.02−0.0100.01Difference, mm Hg·s/mL (linear scale) |
LV vascular load after renal denervation (HFpEF) · 3 months
- Symptomatic improvement in HFpEF
Original publication
Modulation of Pulsatile Left Ventricular Afterload by Renal Denervation in Heart Failure With Preserved Ejection Fraction. Circ Heart Fail. Published 30 August 2023. doi:10.
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