Effects of renal denervation on vascular remodelling in patients with heart failure and preserved ejection fraction: A randomised control trial

OBJECTIVE: To assess the effect of renal denervation (RDT) on micro- and macro-vascular function in patients with heart failure with preserved ejection fraction (HFpEF). DESIGN: A prospective, randomised, open-controlled trial with blinded end-point analysis. SETTING: A single-centre London teaching hospital. PARTICIPANTS: Twenty-five patients with HFpEF who were recruited into the RDT-PEF trial. MAIN OUTCOME MEASURES: Macro-vascular: 24-h ambulatory pulse pressure, aorta distensibilty (from cardiac magnetic resonance imaging (CMR), aorta pulse wave velocity (CMR), augmentation index (peripheral tonometry) and renal artery blood flow indices (renal MR). Micro-vascular: endothelial function (peripheral tonometry) and urine microalbuminuria. RESULTS: At baseline, 15 patients were normotensive, 9 were hypertensive and 1 was hypotensive. RDT did not lower any of the blood pressure indices. Though there was evidence of abnormal vascular function at rest, RDT did not affect these at 3 or 12 months follow-up. CONCLUSIONS: RDT did not improve markers of macro- and micro-vascular function.