Dénervation rénale dans le traitement de l’hypertension artérielle résistante : expérience du CHU de Lyon |
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Authors: | P-Y Courand R Dauphin O Rouvière V Paget F Khettab C Bergerot B Harbaoui G Bricca J-P Fauvel P Lantelme |
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Institution: | 1. Service de cardiologie, hôpital de la Croix-Rousse, hospices civils de Lyon, 103, grande rue de la Croix-Rousse, 69004 Lyon, France;2. Service de radiologie, hôpital Edouard-Herriot, hospices civils de Lyon, 69008 Lyon, France;3. Service de néphrologie, hôpital Edouard-Herriot, hospices civils de Lyon, 69008 Lyon, France;4. EA 4173, génomique fonctionnelle de l’hypertension artérielle, université Claude-Bernard Lyon1, 69100 Villeurbanne, France;5. Hôpital Nord-Ouest, 69400 Villefranche sur Saône, France;6. Service de cardiologie, hôpital Nord-Ouest, 69008 Villefranche sur Saône, France;g Service de cardiologie, hôpital Louis-Pradel, hospices civils de Lyon, 69400 Lyon, France |
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Abstract: | AimWe report the first experience of Lyon's university hospital regarding renal denervation to treat patients with resistant essential hypertension.Patients and methodsOver a one-year period, 17 patients were treated (12 men, 5 women) with renal denervation. Baseline characteristics were as follows: age 56.5 ± 11.5 years, BMI 33 ± 5 kg/m2 and ambulatory blood pressure 157 ± 16/87 ± 13 mmHg with 4.2 ± 1.5 anti-hypertensive treatment.ResultsWe did not observe per procedural and early complications. After a median follow-up of 3 months and with the same anti-hypertensive treatment, office systolic blood pressure (SBP) and diastolic blood pressure (DBP) decrease respectively of 20 ± 15 (P < 0.001) and 10 ± 13 mmHg (P = 0.014) (n = 17). After six months of follow-up, ambulatory blood pressure (ABPM) decrease of 17.5 ± 14.9 mmHg (P = 0.027) for SBP and of 10.5 ± 9.6 mmHg (P = 0.029) for DBP (n = 6). Among these patients, five of them were controlled (ABPM inferior to 130/80 mmHg) and electrical left ventricular hypertrophy indexes decreased: R wave in aVL lead of 4 ± 3 mm (P = 0.031), Sokolow index of 3 ± 3 mm (P = 0.205), Cornell voltage criterion of 9 ± 7 mm (P = 0.027) and Cornell product of 1310 ± 1104 (P = 0.027).ConclusionOur results are in accordance with data from other centers. On average blood pressure decreases significantly but important inter individual variations are observed. The procedure seems safe. |
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Keywords: | Dé nervation ré nale Hypertension essentielle Hypertension ré sistante Hypertrophie ventriculaire gauche NT-proBNP |
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