Recent trial results support catheter-based renal denervation (RDN) for treatment of hypertension, while the exact mechanisms causing blood pressure to fall remain incompletely understood. Cardiac magnetic resonance imaging was used to assess the effects of RDN on cardiac function in patients with hypertension undergoing RDN and compared with sham treatment. Cardiac magnetic resonance imaging was used to assess stroke volume index, cardiac index, heart rate, systemic vascular resistance index, and stroke work index from aortic flow measurements. Patients with resistant hypertension from a randomized, sham-controlled RDN trial underwent cardiac magnetic resonance imaging before RDN and at follow-up (randomized cohort). Results were then validated in a cohort of patients with resistant hypertension undergoing RDN and cardiac magnetic resonance imaging (validation cohort). In total, 162 patients were included 52 patients in the randomized trial (27 shams) and 110 patients in the validation cohort. In the randomized cohort, stroke volume index was reduced by 4.7±9.8 mL/m2 in the RDN cohort and remained unchanged in the sham cohort (P=0.008 for between-group comparison), while cardiac index and stroke work index tended to be reduced in RDN patients but not in sham patients (−0.10±5.9 versus 0.17±0.51 L/min per m2 and −7.1±12.5 versus −1.4±10.4 g/m2, P=0.08 for both). In contrast, systemic vascular resistance index and heart rate remained unchanged after RDN. In the validation cohort, reduction of stroke volume index was confirmed, and cardiac index and stroke work index were also reduced significantly, whereas systemic vascular resistance index and heart rate remained unchanged at follow-up. In this study of patients with resistant hypertension, RDN resulted in a reduction of stroke volume when compared with sham.

中文翻译：

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肾去神经支配后中风量的变化

最近的试验结果支持基于导管的肾去神经支配 (RDN) 治疗高血压，而导致血压下降的确切机制仍未完全了解。心脏磁共振成像用于评估 RDN 对接受 RDN 的高血压患者心脏功能的影响，并与假治疗进行比较。心脏磁共振成像用于评估来自主动脉流量测量的每搏输出量指数、心脏指数、心率、全身血管阻力指数和每搏工作指数。来自随机、假对照 RDN 试验的顽固性高血压患者在 RDN 之前和随访时（随机队列）接受了心脏磁共振成像。然后在接受 RDN 和心脏磁共振成像的顽固性高血压患者队列（验证队列）中验证结果。总共有 162 名患者被纳入随机试验中的 52 名患者（27 名假手术）和 110 名患者的验证队列。在随机队列中，RDN 队列中每搏量指数降低了 4.7±9.8 mL/m2，而在假队列中保持不变（组间比较 P=0.008），而心脏指数和每搏功指数趋于降低在 RDN 患者而非假手术患者中（-0.10±5.9 与 0.17±0.51 L/min/m2 和 -7.1±12.5 与 -1.4±10.4 g/m2，两者的 P=0.08）。相比之下，全身血管阻力指数和心率在 RDN 后保持不变。在验证队列中，确认每搏输出量指数降低，心脏指数和中风工作指数也显着降低，而全身血管阻力指数和心率在随访时保持不变。在这项针对顽固性高血压患者的研究中，与假手术相比，RDN 导致每搏输出量减少。