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Magnetic-Resonance Tomography for Anthropometric Value of Kidneys and Adrenals in Prognosis Efficiency of Renal Sympathetic Denervation in Patients with Treatment-Resistant Hypertension

https://doi.org/10.24835/1607-0763-2017-4-58-64

Abstract

Aim: to evaluate the possible role of contrast-enhanced MRI studies  of the kidneys in prognosis of clinical effect of the renal denervation treatment of the resistant hypertension.

Material and methods. 24 patients (57.8 ± 8.75 years) with  resistant hypertension were included, in everybody the  radiofrequency ablation (RFA) of the sympathetic nerves of renal  arteries was carried out. The average 24-h monitor of the arterial  pressure was as 137–210/57–148 mm Hg. The MRI studies were  performed using MRI scanner “Titan Vantage” (by “Toshiba Medical  Ltd”, with the field induction 1.5 Т). After this the intravenous  contrast enhancement has been carried out (with 0.5 М solution, 0.2 ml/Kg), with repeat acquisition of Т1-weighted spin-echo images in
3–5 min after contrast injection.

Results. MRI was employed for quantitative calculation of renal  volumes of cortex, medulla and of kidney as total, as well as of  suprarenal’s volume. Significant negative correlation of postoperation decrease of arterial pressure has been detected with both volume of renal cortex, as {Decrease in AP = 42.7–0.35 • (V left kidney)}, and  also with mass of the right suprarenal gland as {Decrease in  SAP = 16.5–6.78 • • (V right suprarenal)}.

Conclusion. The anatomic quantitative data of the preoperative
MRI studies of the kidneys can be employed as prognostic tool in  patients referred to the renal denervation treatment of the resistant hypertension.

About the Authors

N. I. Ryumshina
Cardiology Research Institute of Tomsk National Research Medical Centre, Russian Academy of Sciences
Russian Federation

Competing Interests:

graduate student of the roentgenologic and tomography diagnostic laboratory of the Cardiology Research Institute of Tomsk National Research Medical Centre, Russian Academy of Sciences, Tomsk

634012 Russia, Tomsk, Kievskaya str., 111a. Tomsk Institute of Cardiology, Laboratory of tomography. Phone: +7-953-916-50-41



P. I. Lukyanenok
Cardiology Research Institute of Tomsk National Research Medical Centre, Russian Academy of Sciences
Russian Federation

Competing Interests:

doct. of med. sci., Chairman of the MRI department of the Cardiology Research Institute of Tomsk National Research Medical Centre of Russian Academy of Sciences, Tomsk



V. F. Mordovin
Cardiology Research Institute of Tomsk National Research Medical Centre, Russian Academy of Sciences
Russian Federation

Competing Interests:

doct. of med. sci., Chairman of the arterial hypertonia department of the Cardiology Research Institute of Tomsk National Research Medical Centre of Russian Academy of Sciences, Tomsk



V. Yu. Usov
Cardiology Research Institute of Tomsk National Research Medical Centre, Russian Academy of Sciences
Russian Federation

Competing Interests:

doct. of med. sci., Chairman of the roentgenologic and tomography diagnostic laboratory of the Cardiology Research Institute of Tomsk National Research Medical Centre of Russian  Academy of Sciences, Tomsk



References

1. Mancia G., Fagard R. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J. Hypertension. 2013; 31 (7): 1281–1357. DOI: 10.1097/01.hjh.0000431740.32696.cc.

2. Ripp T.M., Mordovin V.F., Pekarskij S.E., Ryabova T.R., Zlobina M.V., Krylov A.L., Lichikaki V.A., Popov S.V., Karpov R.S. Sympathetic denervation of the renal arteries for the treatment of resistant hypertension – safety control by ultrasound diagnostics. Arterialnaya gipertenziya. 2013; 2 (19): 139–147. (In Russian)

3. Sulimov V.A., Rodionov A.V., Svetankova A.A., Deneka I.H. Renal denervation in resistant arterial hypertension. Ratsionalnaya farmakoterapiya v kardiologii. 2013; 9 (3): 274–279. (In Russian)

4. Sinkova G.M. Epidemiology of arterial hypertension. Sibirskiy medicinskiy zhurnal. 2007; 8: 5–10. (In Russian)

5. Esler M.D. Renal sympathetic denervation in patients with treatment-resistant hypertension (The Symplicity HTN-2 Trial): a randomised controlled trial. Lancet. 2010; 376 (9756): 1903–1909. DOI:10.1016/S0140-6736(10)62039-9.

6. Kandzari D.E. Catheter-Based Renal Denervation for Resistant Hypertension: Rationale and Design of the SYMPLICITY HTN-3 Trial. Clin. Cardiol. 2012; 35 (9): 528–535. DOI:10.1002/clc.22008.

7. Krum H., Schlaich M., Sobotka P. Renal sympathetic nerve ablation for treatment- resistant hypertension. Br. J. Clin. Pharmacol. 2013; 76 (4): 495–503. DOI:10.1111/bcp.12171.

8. Esler M. D., Krum H., Schlaich M., Schmieder R.E.,. Böhm M, Sobotka P.A. Renal sympathetic denervation for treatment of drug-resistant hypertension. One-year results from the Symplisity HTN-2 randomized, controlled trial. Circulation. 2012; 126: 2976–2982. DOI: 10.1161/CIRCULATIONAHA.112.130880.

9. Matchin Ju.G., Grigin V.A., Danilov N.M., Shhelkova G.V., Chazova I.E. Radio frequency denervation of renal arteries in the treatment of resistant arterial hypertension – annual results. Atmosphera. Novosti kardiologii. 2013; (3): 12–18. (In Russian)

10. Brandão A.A., Gonçalves Campana E.M., Campos Magalhães M.E., Ferreira E. Renal sympathetic dener vation for resistant hypertension treatment: current perspectives. Arquivos Brasileiros de Cardiologia. 2013; 101 (4): 364–371. DOI: 10.5935/abc.20130187.

11. Lobo M.D., de Belder M.A., Cleveland T., Collier D., Dasgupta I., Deanfield J., Kapil V. Joint UK societies’ 2014 consensus statement on renal denervation for resistant hypertension. Heart. 2015; 101: 10–16. DOI:10.1136/heartjnl-2014-307029.

12. Lukjanenok P.I., Usov V.Ju., Gudkov A.V., Belichenko A.V. Estimation of kidneys size and intensity of a signal from cortical and medullar substance according to magnetic resonance imaging data. Terapevt. 2014; 4: 65–70. (In Russian)

13. Lukjanenok P.I. Magnetic resonance imaging of adrenal glands in patients with arterial hypertension when a prospective observation. The verge of norm and pathology. Manual. Tomsk: Veter, 2016: 51–87. (In Russian)

14. Chihladze N.M., Chazova I.E. Arterial hypertonia and kidneys. Consilium Medicum. 2015; 10: 8–12. (In Russian)

15. Rjumshina N.I., Mordovin V.F., Luk'janenok P.I., Usov V.Yu. Use of magnetic resonance imaging with paramagnetic contrast in evaluation of local renal denervation impact on the renal arteries walls. Luchevaya diagnostika i terapiya. 2015; 3 (6): 83–89. (In Russian)

16. Mochula O.V., Sitkova E.S., Mordovin V.F., Boguneckij A.A., Luk'yanenok P.I., Usov V.Yu. Contrast-enhanced magnetic resonance imaging in the follow-up of subendocardial myocardial damage in patients with drug-resistant arterial hypertension treated using radiofrequency ablation of renal arteries. Sibirskij medicinskij zhurnal. 2014; 29 (3): 62–67. (In Russian)

17. Gillis K.A., McComb Ch., Foster J.E., Taylor A.H.M., Patel R.K., Morris S.TW., Jardine A.G., Schneider M.P., Roditi G.H., Delles Ch., Mark P.B. Inter-study reproducibility of arterial spin labeling magnetic resonance imaging for measurement of renal perfusion in healthy volunteers at 3 Tesla. BMC Nephrology. 2014; 15: 23, 1–10. DOI:10.1186/1471-2369-15-23.


Review

For citations:


Ryumshina N.I., Lukyanenok P.I., Mordovin V.F., Usov V.Yu. Magnetic-Resonance Tomography for Anthropometric Value of Kidneys and Adrenals in Prognosis Efficiency of Renal Sympathetic Denervation in Patients with Treatment-Resistant Hypertension. Medical Visualization. 2017;(4):58-64. (In Russ.) https://doi.org/10.24835/1607-0763-2017-4-58-64

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