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Renal denervation

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https://www.readbyqxmd.com/read/28942601/should-we-take-renal-denervation-with-a-grain-of-salt
#1
Baris Afsar, Alan A Sag, Mehmet Kanbay
No abstract text is available yet for this article.
September 24, 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28938966/high-screen-failure-rate-in-patients-with-resistant-hypertension-findings-from-symplicity-htn-3
#2
Ron Waksman, George L Bakris, Arie Steinvil, Hector Garcia-Garcia, Angela L Brown, William DiFilippo, Thomas Scott, Jasvindar Singh, Vanessa DeBruin, Denise Jones, Dan Jolivette, Deepak L Bhatt
BACKGROUND: The SYMPLICITY HTN-3 trial, which randomized subjects to renal denervation (RDN) or sham control, was designed to evaluate the efficacy and safety of RDN for the treatment of resistant hypertension. Outcomes were previously reported. This retrospective analysis evaluated reasons for screen failure (SF) for randomization in the trial. METHODS: SYMPLICITY HTN-3 enrolled subjects with office systolic blood pressure (SBP) ≥160 mmHg on stable and maximal doses of ≥3 antihypertensive medication classes...
October 2017: American Heart Journal
https://www.readbyqxmd.com/read/28936180/mouse-anaphylactic-hypotension-is-characterized-by-initial-baroreflex-independent-renal-sympathoinhibition-followed-by-sustained-renal-sympathoexcitation
#3
Tao Zhang, Mamoru Tanida, Kunitoshi Uchida, Yoshiro Suzuki, Wei Yang, Yuhichi Kuda, Yasutaka Kurata, Makoto Tominaga, Toshishige Shibamoto
Aim: The hemodynamic response to mouse systemic anaphylaxis is characterized by an initial hypertension followed by sustained hypotension. However, the defense mechanisms of the sympathetic nervous system against this circulatory disturbance is not known. Here, we investigated the renal sympathetic nerve activity (RSNA) response to mouse systemic anaphylaxis, along with the roles of carotid sinus baroreceptor, vagal nerves and the transient receptor potential vanilloid type 1 channel (TRPV1). Methods: Male ovalbumin-sensitized C57BL/6N mice were used under pentobarbital anesthesia...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28929577/salt-intake-and-blood-pressure-response-to-percutaneous-renal-denervation-in-resistant-hypertension
#4
Esther de Beus, Rosa L de Jager, Martine M Beeftink, Margreet F Sanders, Wilko Spiering, Evert-Jan Vonken, Michiel Voskuil, Michiel L Bots, Peter J Blankestijn
The effect of lowering sympathetic nerve activity by renal denervation (RDN) is highly variable. With the exception of office systolic blood pressure (BP), predictors of the BP-lowering effect have not been identified. Because dietary sodium intake influences sympathetic drive, and, conversely, sympathetic activity influences salt sensitivity in hypertension, we investigated 24-hour urinary sodium excretion in participants of the SYMPATHY trial. SYMPATHY investigated RDN in patients with resistant hypertension...
September 19, 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28919800/renal-sympathetic-denervation-increases-renal-blood-volume-per-cardiac-cycle-a-serial-magnetic-resonance-imaging-study-in-resistant-hypertension
#5
Sinny Delacroix, Ramesh G Chokka, Adam J Nelson, Dennis T Wong, Samuel Sidharta, Stephen M Pederson, Adil Rajwani, Joanne Nimmo, Karen S Teo, Stephen G Worthley
AIM: Preclinical studies have demonstrated improvements in renal blood flow after renal sympathetic denervation (RSDN); however, such effects are yet to be confirmed in patients with resistant hypertension. Herein, we assessed the effects of RSDN on renal artery blood flow and diameter at multiple time points post-RSDN. METHODS AND RESULTS: Patients (n=11) with systolic blood pressures ≥160 mmHg despite taking three or more antihypertensive medications at maximum tolerated dose were recruited into this single-center, prospective, non-blinded study...
2017: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/28905871/hypertension-proof-of-concept-for-renal-denervation
#6
Irene Fernández-Ruiz
No abstract text is available yet for this article.
September 14, 2017: Nature Reviews. Cardiology
https://www.readbyqxmd.com/read/28885911/renal-denervation-what-happened-and-why
#7
REVIEW
Mehdi H Shishehbor, Tarek A Hammad, George Thomas
Despite promising results in initial trials, renal denervation failed to achieve its efficacy end points as a treatment for resistant hypertension in the SYMPLICITY HTN-3 trial, the largest trial of this treatment to date (N Engl J Med 2014; 370:1393-1401). Is renal denervation dead, or will future trials and newer technology revive it?
September 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/28885900/renal-denervation-are-we-on-the-right-path
#8
EDITORIAL
Ali E Denktas, David Paniagua, Hani Jneid
No abstract text is available yet for this article.
September 2017: Cleveland Clinic Journal of Medicine
https://www.readbyqxmd.com/read/28880055/resistant-hypertension-an-overview
#9
Roberto Pedrinelli, Giulia Dell' Omo, Giuseppe Ambrosio, Matteo Cameli, Elisabetta Cerbai, Stefano Coiro, Michele Emdin, Riccardo Liga, Rossella Marcucci, Doralisa Morrone, Alberto Palazzuoli, Luigi Padeletti, Ketty Savino
Despite the availability of anti-hypertensive medications with proven efficacy and good tolerability, many hypertensive patients have blood pressure levels(BP) not at the goals set by international societies. Some of these patients are either non-adherent to the prescribed drugs or not optimally treated. However, a proportion, despite adequate treatment, has resistant hypertension(RH) defined as office BP above goal despite the use of ≥3 antihypertensive medications at maximally tolerated doses (one ideally being a diuretic)...
September 5, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28864691/efficacy-and-safety-of-renal-denervation-for-chinese-patients-with-resistant-hypertension-using-a-microirrigated-catheter-study-design-and-protocol-for-a-prospective-multicentre-randomised-controlled-trial
#10
Zongjun Liu, Li Shen, Weijian Huang, Xianxian Zhao, Weiyi Fang, Changqian Wang, Zhaofang Yin, Jianan Wang, Guosheng Fu, Xuebo Liu, Jianjun Jiang, Zhihui Zhang, Jingbo Li, Yingmin Lu, Junbo Ge
INTRODUCTION: Available data show that approximately 8%-18% of patients with primary hypertension will develop resistant hypertension. In recent years, catheter-based renal denervation (RDN) has emerged as a potential treatment option for resistant hypertension. A number of observational studies and randomised controlled trials among non-Chinese patients have demonstrated its potential safety and efficacy. METHODS AND ANALYSIS: This is a multicentre, randomised, open-label, parallel-group, active controlled trial that will investigate the efficacy and safety of a 5F saline-irrigated radiofrequency ablation (RFA) used for RDN in the treatment of Chinese patients with resistant hypertension...
September 1, 2017: BMJ Open
https://www.readbyqxmd.com/read/28862930/blood-pressure-response-to-main-renal-artery-and-combined-main-renal-artery-plus-branch-renal-denervation-in-patients-with-resistant-hypertension
#11
Karl Fengler, Sebastian Ewen, Robert Höllriegel, Karl-Philipp Rommel, Saaraaken Kulenthiran, Lucas Lauder, Bodo Cremers, Gerhard Schuler, Axel Linke, Michael Böhm, Felix Mahfoud, Philipp Lurz
BACKGROUND: Single-electrode ablation of the main renal artery for renal sympathetic denervation showed mixed blood pressure (BP)-lowering effects. Further improvement of the technique seems crucial to optimize effectiveness of the procedure. Because sympathetic nerve fibers are closer to the lumen in the distal part of the renal artery, treatment of the distal main artery and its branches has been shown to reduce variability in treatment effects in preclinical studies and a recent randomized trial...
August 10, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28859945/catheter-based-renal-denervation-for-treatment-of-hypertension
#12
Michel Azizi
No abstract text is available yet for this article.
August 25, 2017: Lancet
https://www.readbyqxmd.com/read/28859944/catheter-based-renal-denervation-in-patients-with-uncontrolled-hypertension-in-the-absence-of-antihypertensive-medications-spyral-htn-off-med-a-randomised-sham-controlled-proof-of-concept-trial
#13
Raymond R Townsend, Felix Mahfoud, David E Kandzari, Kazuomi Kario, Stuart Pocock, Michael A Weber, Sebastian Ewen, Konstantinos Tsioufis, Dimitrios Tousoulis, Andrew S P Sharp, Anthony F Watkinson, Roland E Schmieder, Axel Schmid, James W Choi, Cara East, Anthony Walton, Ingrid Hopper, Debbie L Cohen, Robert Wilensky, David P Lee, Adrian Ma, Chandan M Devireddy, Janice P Lea, Philipp C Lurz, Karl Fengler, Justin Davies, Neil Chapman, Sidney A Cohen, Vanessa DeBruin, Martin Fahy, Denise E Jones, Martin Rothman, Michael Böhm
BACKGROUND: Previous randomised renal denervation studies did not show consistent efficacy in reducing blood pressure. The objective of our study was to evaluate the effect of renal denervation on blood pressure in the absence of antihypertensive medications. METHODS: SPYRAL HTN-OFF MED was a multicentre, international, single-blind, randomised, sham-controlled, proof-of-concept trial. Patients were enrolled at 21 centres in the USA, Europe, Japan, and Australia...
August 25, 2017: Lancet
https://www.readbyqxmd.com/read/28845853/-resistant-hypertension-in-the-elderly
#14
Paolo Cicconetti, Alessandra Di Berardino, Maria Tortorelli D'Ambrosio, Mauro Cacciafesta
Actually, in literature there are no epidemiologic studies on the prevalence of resistant hypertension in the elderly; however the National Health and Nutrition Examination Survey observed in the adult population prevalence of 12.8% to clinical measurement. But, especially in elderly, it's necessary exclude pseudoresistance forms due to white coat hypertension, arterial stiffness, poor patient compliance to therapy, excessive salt intake, abuse of non-steroidal ant-inflammatory drugs and the forms of secondary hypertension...
July 2017: Recenti Progressi in Medicina
https://www.readbyqxmd.com/read/28845508/impact-of-renal-denervation-on-tissue-na-content-in-treatment-resistant-hypertension
#15
Christian Ott, Christoph Kopp, Anke Dahlmann, Axel Schmid, Peter Linz, Alexander Cavallaro, Matthias Hammon, Tilmann Ditting, Roland Veelken, Michael Uder, Jens Titze, Roland E Schmieder
OBJECTIVES: Renal denervation (RDN) has been introduced for reducing blood pressure (BP) in treatment-resistant hypertension (TRH). The precise mechanism how RDN exerts its BP-lowering effects are not yet fully understood. It is widely accepted that sodium (Na(+)) plays a crucial role in the pathogenesis of hypertensive disease. However, there is increasing evidence of osmotically inactive Na(+) storage. We investigated the impact of RDN on Na(+) homeostasis using estimation of salt intake, and measurement of tissue Na(+) content...
August 28, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28835849/the-impact-on-central-blood-pressure-and-arterial-stiffness-post-renal-denervation-in-patients-with-stage-3-and-4-chronic-kidney-disease-the-prairie-renal-denervation-study
#16
Bhanu Prasad, Jennifer Rose St Onge, Michelle C E McCarron, Kunal Goyal, Payam Dehghani
BACKGROUND: Central aortic blood pressures and arterial stiffness are better indicators of cardiovascular outcomes than brachial blood pressures. However, their response to renal denervation (RDN) in patients with stage 3 and stage 4 chronic kidney disease (CKD) has not yet been examined. OBJECTIVE: To evaluate the impact of RDN on central blood pressures, brachial (office and ambulatory) blood pressures, arterial stiffness, glomerular filtration rate (GFR), 24-hour urine protein, and selective cardiac parameters observed on echocardiograms...
2017: Canadian Journal of Kidney Health and Disease
https://www.readbyqxmd.com/read/28833735/renal-denervation-decreases-susceptibility-of-the-heart-to-ventricular-fibrillation-in-a-canine-model-of-chronic-kidney-disease
#17
Xiaotie Tang, Lang Shi, Xuebin Cui, Yang Yu, Ting Qi, Cheng Chen, Xianglei Tang
Renal denervation (RDN) has been shown to have therapeutic values in patients with chronic kidney disease (CKD). This study aimed to investigate whether RDN could decrease susceptibility of the heart to ventricular fibrillation in a canine model of CKD. Twenty-one dogs were included in this study. CKD was produced by subtotal nephrectomy in sixteen dogs with RDN treatment (CKD + RDN group, N = 8) or sham RDN (CKD group, N = 8). Another 5 dogs underwent sham operation and sham RDN to serve as controls (CTR group)...
August 21, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/28830251/the-effect-of-renal-denervation-on-arterial-stiffness-central-blood-pressure-and-heart-rate-variability-in-treatment-resistant-essential-hypertension-a-substudy-of-a-randomized-sham-controlled-double-blinded-trial-the-reset-trial
#18
Christian Daugaard Peters, Ole Norling Mathiassen, Henrik Vase, Jesper Bech Nørgaard, Kent Lodberg Christensen, Anne Pauline Schroeder, Hans Joachim von Hofe Rickers, Ulla Kampmann Opstrup, Per Løgstrup Poulsen, Sten Langfeldt, Gratien Andersen, Klavs Würgler Hansen, Hans Erik Bøtker, Morten Engholm, Jannik Buus Bertelsen, Erling Bjerregaard Pedersen, Anne Kaltoft, Niels Henrik Buus
OBJECTIVES: To investigate, whether renal denervation (RDN) improves arterial stiffness, central blood pressure (C-BP) and heart rate variability (HRV) in patients with treatment resistant hypertension. METHODS: ReSET was a randomized, sham-controlled, double-blinded trial (NCT01459900). RDN was performed by a single experienced operator using the Medtronic unipolar Symplicity Flex(TM) catheter. C-BP, carotid-femoral pulse wave velocity (PWV), and HRV were obtained at baseline and after six months with the SphygmoCor(®)-device...
August 23, 2017: Blood Pressure
https://www.readbyqxmd.com/read/28818859/renal-denervation-suppresses-coronary-hyperconstricting-responses-after-drug-eluting-stent-implantation-in-pigs-in-vivo-through-the-kidney-brain-heart-axis
#19
Hironori Uzuka, Yasuharu Matsumoto, Kensuke Nishimiya, Kazuma Ohyama, Hideaki Suzuki, Hirokazu Amamizu, Susumu Morosawa, Michinori Hirano, Tomohiko Shindo, Yoku Kikuchi, Kiyotaka Hao, Takashi Shiroto, Kenta Ito, Jun Takahashi, Koji Fukuda, Satoshi Miyata, Yoshihito Funaki, Hatsue Ishibashi-Ueda, Satoshi Yasuda, Hiroaki Shimokawa
OBJECTIVE: Drug-eluting stent-induced coronary hyperconstricting responses remain an important issue. The adventitia harbors a variety of components that potently modulate vascular tone, including sympathetic nerve fibers (SNF) and vasa vasorum. Catheter-based renal denervation (RDN) inhibits sympathetic nerve activity. We, thus, examined whether RDN suppresses drug-eluting stent-induced coronary hyperconstricting responses, and if so, what mechanisms are involved. APPROACH AND RESULTS: Protocol 1: pigs implanted with everolimus-eluting stents into the left coronary arteries underwent coronary angiography at 1 month after implantation for assessment of coronary vasomotion and adventitial SNF formation...
August 17, 2017: Arteriosclerosis, Thrombosis, and Vascular Biology
https://www.readbyqxmd.com/read/28815689/medication-adherence-in-patients-with-apparent-resistant-hypertension-findings-from-the-sympathy-trial
#20
R L de Jager, E M van Maarseveen, M L Bots, P J Blankestijn
INTRODUCTION: Hypertension is only controlled in approximately 35% of the patients, which could be partially due to non-adherence. Recently, bioanalytical assessment of adherence to blood pressure (BP) lowering drugs has gaining interest. Our aim was to explore possible determinants of non-adherence in treatment resistant hypertension, assessed by objective screening for antihypertensive agents in serum. Secondary aim was to study the effect of adherence on the change in BP. METHODS: This project was a sub-study of SYMPATHY; an open-label randomized-controlled trial to assess the effect of renal denervation on BP six months after treatment compared to usual care in patients with resistant hypertension...
August 17, 2017: British Journal of Clinical Pharmacology
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