LONG-TERM PROGNOSIS OF PATIENTS WHO HAVE PERFORMED RENAL DENERVATION USING TWO TYPE DEVICES WITHOUT CHANGING THEIR ANTI-HYPERTENSIVES

Objective: Although catheter-based renal denervation (RDN) has been proven to provide blood pressure (BP) reductions in various clinical trials, there have been few reports of long-term outcomes post-RDN without any change in anti-hypertensives. Design and method: The hospital participated in two separate RDN clinical trials using ultrasonic balloon-type device and spiral electrode catheter. Detailed analysis of ambulatory BP monitoring up to 5 years was performed (3,6 months, 1,2,3,4,5 years after RDN). Results: The 8 patients were enrolled, and the analysis excluded cases in which the medication was changed because of variant angina pectoris and prominent postoperative BP reduction. After RDN, a sustained BP reduction was confirmed, especially up to 3 years. Compared to pre-RDN, averaged BP reduction in systolic BP (SBP) and diastolic BP (DBP) of the 7 points after RDN were -8.7mmHg (p<0.05) and -5.2mmHg (p<0.05), respectively. The BP reduction was particularly more prominent at nighttime; SBP with -12.2mmHg (p<0.05) and DBP with -7.7mmHg (p<0.01), respectively. Furthermore, the higher the preoperative SBP (R=0.947, p<0.005) and DBP (R=0.813, p<0.05), the greater the decrease in SBP after RDN. In addition, the lower the preoperative BMI (R=-0.857, p<0.05) or the higher the dopamine level (R=0.873, p<0.05), the greater the decrease in DBP after RDN. There was no significant difference in BP reduction due to device difference. Conclusions: Long-term BP reduction by RDN, especially at nighttime when the BP reduction with anti-hypertensives attenuated, was confirmed. If stable BP reduction is maintained by RDN for long period, it could contribute to improvement of life prognosis.