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- Title
The effect of renal denervation on kidney oxygenation as determined by BOLD MRI in patients with hypertension.
- Authors
Vink, E.; Boer, A.; Verloop, W.; Spiering, W.; Voskuil, M.; Vonken, E.; Hoogduin, J.; Leiner, T.; Bots, M.; Blankestijn, P.
- Abstract
Objectives: Renal denervation (RDN) is a promising therapy for resistant hypertension. RDN is assumed to decrease sympathetic activity. Consequently, RDN can potentially increase renal oxygenation. Blood oxygen level-dependent MRI (BOLD-MRI) provides a non-invasive tool to determine renal oxygenation in humans. The aim of the current study was to investigate the effect of RDN on renal oxygenation as determined by BOLD-MRI. Methods: Patients with resistant hypertension or the inability to follow a stable drug regimen due to unacceptable side effects were included. BOLD-MRI was performed before and 12 months after RDN. Twenty-seven patients were imaged on 3 T and 19 on 1.5 T clinical MRI systems. Results: Fifty-four patients were included, 46 patients (23 men, mean age 57 years) completed the study. Mean 24-h BP changed from 163(±20)/98(±14) mmHg to 154(±22)/92(±13) mmHg ( p = 0.001 and p < 0.001). eGFR did not change after RDN [77(±18) vs. 79(±20) mL/min/1.73 m p = 0.13]. RDN did not affect renal oxygenation [1.5 T: cortical R2*: 12.5(±0.9) vs. 12.5(±0.9), p = 0.94; medullary R2*: 19.6(±1.7) vs. 19.3(1.4), p = 0.40; 3 T: cortical R2*: 18.1(±0.8) vs. 17.8(±1.2), p = 0.47; medullary R2*: 27.4(±1.9) vs. 26.7(±1.8), p = 0.19]. Conclusion: The current study shows that RDN does not lead to changes in renal oxygenation 1 year after RDN as determined by BOLD-MRI. Key Points: • Renal denervation significantly decreased ambulatory blood pressure. • Renal denervation did not change renal oxygenation as determined by BOLD- MRI. • Absence of a change in renal oxygenation might be explained by autoregulation.
- Subjects
DENERVATION; HYPERTENSION; THERAPEUTICS; THERAPEUTIC use of magnetic resonance imaging; CATHETER ablation; OXYGEN therapy; RENAL artery; SURGERY
- Publication
European Radiology, 2015, Vol 25, Issue 7, p1984
- ISSN
0938-7994
- Publication type
Article
- DOI
10.1007/s00330-014-3583-1