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Renal denervation

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https://www.readbyqxmd.com/read/28338871/renal-sympathetic-denervation-a-viable-option-for-treating-resistant-hypertension
#1
Markus P Schlaich
Accumulating evidence from mainly uncontrolled clinical studies with various types of ablation catheters have shown that renal denervation (RDN) can be applied safely and is effective in lowering blood pressure (BP) in patients with treatment-resistant hypertension. Sustained BP lowering has been documented up to 3 years. Furthermore, RDN has been associated with regression of target organ damage, such as left ventricular hypertrophy, arterial stiffness, and others. Several studies indicate potential benefit in other common clinical conditions associated with increased sympathetic tone including chronic kidney disease and heart failure...
March 1, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28338768/integrative-blood-pressure-response-to-upright-tilt-post-renal-denervation
#2
Erin J Howden, Cara East, Justin S Lawley, Abigail S L Stickford, Myrthe Verhees, Qi Fu, Benjamin D Levine
BACKGROUND: Whether renal denervation (RDN) in patients with resistant hypertension normalizes blood pressure (BP) regulation in response to routine cardiovascular stimuli such as upright posture is unknown. We conducted an integrative study of BP regulation in patients with resistant hypertension who had received RDN to characterize autonomic circulatory control. METHODS: Twelve patients (60 ± 9 [SD] years, n = 10 males) who participated in the Symplicity HTN-3 trial were studied and compared to 2 age-matched normotensive (Norm) and hypertensive (unmedicated, HTN) control groups...
February 20, 2017: American Journal of Hypertension
https://www.readbyqxmd.com/read/28322494/finding-the-best-ablation-strategy-for-renal-denervation-a-continuing-saga
#3
Kyriakos Dimitriadis, Costas Tsioufis, Dimitrios Tousoulis
No abstract text is available yet for this article.
March 21, 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28314642/hypotensive-effects-of-renal-denervation-in-spontaneously-hypertensive-rat-based-on-ultrasonic-contrast-imaging
#4
Ke Li, Jinwen Tian, Yuxiao Zhang, Qiao Xue, Caiyi Lu
BACKGROUND: Sympathetic nerves-fire rate is generally enhanced in some types of hypertension models. Renal sympathetic denervation(RSD) by the radiofrequency ablation was used to treat the hypertension has achieved curative effect.HTN-1 and HTN-2 trial reported catheter-based renal denervation may cause substantial and sustained blood-pressure reduction in patients with resistant hypertension. However, recent controlled HTN-3 trial questioned the BP lowering effect of Renal denervation treatment...
February 9, 2017: Computerized Medical Imaging and Graphics: the Official Journal of the Computerized Medical Imaging Society
https://www.readbyqxmd.com/read/28296025/renal-denervation-beyond-the-bifurcation-the-effect-of-distal-ablation-placement-on-safety-and-blood-pressure
#5
Martine M A Beeftink, Wilko Spiering, Mark R De Jong, Pieter A Doevendans, Peter J Blankestijn, Arif Elvan, Jan-Evert Heeg, Michiel L Bots, Michiel Voskuil
Renal denervation may be more effective if performed distal in the renal artery because of smaller distances between the lumen and perivascular nerves. The authors reviewed the angiographic results of 97 patients and compared blood pressure reduction in relation to the location of the denervation. No significant differences in blood pressure reduction or complications were found between patient groups divided according to their spatial distribution of the ablations (proximal to the bifurcation in both arteries, distal to the bifurcation in one artery and distal in the other artery, or distal to the bifurcation in both arteries), but systolic ambulatory blood pressure reduction was significantly related to the number of distal ablations...
March 14, 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28284503/renal-denervation-regulates-the-atrial-arrhythmogenic-substrates-through-reverse-structural-remodeling-in-heart-failure-rabbit-model
#6
Shinya Yamada, Li-Wei Lo, Yu-Hui Chou, Wei-Lun Lin, Shih-Lin Chang, Yenn-Jiang Lin, Shih-Ann Chen
BACKGROUND: Heart failure (HF) causes atrial remodeling and increases the incidence of atrial fibrillation (AF). Renal denervation (RDN) has been shown to decrease the development of AF. This study aimed to identify the effects of RDN on the atrial arrhythmogenic substrates in HF. METHODS: Rabbits were classified into four groups: control (n=9), RDN (n=10), HF (n=6) and HF-RDN (n=9). Surgical and chemical RDN was approached through bilateral retroperitoneal flank incisions in RDN and HF-RDN...
May 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28276870/renal-sympathetic-denervation-for-treatment-of-patients-with-heart-failure-summary-of-the-available-evidence
#7
Wail Nammas, Juhani Koistinen, Tuomas Paana, Pasi P Karjalainen
Heart failure syndrome results from compensatory mechanisms that operate to restore - back to normal - the systemic perfusion pressure. Sympathetic overactivity plays a pivotal role in heart failure; norepinephrine contributes to maintenance of the systemic blood pressure and increasing preload. Cardiac norepinephrine spillover increases in patients with heart failure; norepinephrine exerts direct toxicity on cardiac myocytes resulting in a decrease of synthetic activity and/or viability. Importantly, cardiac norepinephrine spillover is a powerful predictor of mortality in patients with moderate to severe HF...
February 10, 2017: Annals of Medicine
https://www.readbyqxmd.com/read/28275946/a-network-meta-analysis-of-clinical-management-strategies-for-treatment-resistant-hypertension-making-optimal-use-of-the-evidence
#8
Peter Makai, Joanna IntHout, Jaap Deinum, Kevin Jenniskens, Gert Jan van der Wilt
BACKGROUND: With the addition of surgical interventions to current medicinal treatments, it is increasingly challenging for clinicians to rationally choose among the various options for treating patients with apparent treatment-resistant hypertension (ATRHTN). This study aims to establish the comparative effectiveness of mineralocorticoid receptor antagonists (MRA), renal denervation (RDN), darusentan and central arteriovenous anastomosis (CAA) for patients with ATRHTN by performing a network meta-analysis...
March 8, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28271154/renal-artery-and-parenchymal-changes-after-renal-denervation-assessment-by-magnetic-resonance-angiography
#9
Margreet F Sanders, Pieter Jan van Doormaal, Martine M A Beeftink, Michiel L Bots, Fadl Elmula M Fadl Elmula, Jesse Habets, Frank Hammer, Pavel Hoffmann, Lotte Jacobs, Patrick B Mark, Alexandre Persu, Jean Renkin, Giles Roditi, Wilko Spiering, Jan A Staessen, Alison H Taylor, Willemien L Verloop, Eva E Vink, Evert-Jan Vonken, Michiel Voskuil, Tim Leiner, Peter J Blankestijn
OBJECTIVES: Relatively little is known about the incidence of long-term renal damage after renal denervation (RDN), a potential new treatment for hypertension. In this study the incidence of renal artery and parenchymal changes, assessed with contrast-enhanced magnetic resonance angiography (MRA) after RDN, is investigated. METHODS: This study is an initiative of ENCOReD, a collaboration of hypertension expert centres. Patients in whom an MRA was performed before and after RDN were included...
March 7, 2017: European Radiology
https://www.readbyqxmd.com/read/28268057/renal-sympathetic-denervation-system-via-intraluminal-ultrasonic-ablation-therapeutic-intravascular-ultrasound-design-and-preclinical-evaluation
#10
Gil Chernin, Iris Szwarcfiter, Yvonne Bausback, Michael Jonas
PURPOSE: To assess the safety and performance of a nonfocused and nonballooned ultrasonic (US) catheter-based renal sympathetic denervation (RDN) system in normotensive swine. MATERIALS AND METHODS: RDN with the therapeutic intravascular US catheter was evaluated in 3 experiments: (i) therapeutic intravascular US RDN vs a control group of untreated animals with follow-up of 30, 45, and 90 days (n = 6; n = 12 renal arteries for each group); (ii) therapeutic intravascular US RDN vs radiofrequency (RF) RDN in the contralateral artery in the same animal (n = 2; n = 4 renal arteries); and (iii) therapeutic intravascular US RDN in a recently stent-implanted renal artery (n = 2; n = 4 renal arteries)...
March 3, 2017: Journal of Vascular and Interventional Radiology: JVIR
https://www.readbyqxmd.com/read/28267133/recent-advances-in-the-pathophysiology-of-arterial-hypertension-potential-implications-for-clinical-practice
#11
Dagmara Hering, Andrzej Trzebski, Krzysztof Narkiewicz
Hypertension remains a major and growing public health problem associated with the greatest proportion of global cardiovascular (CV) morbidity and mortality. Although numerous factors contribute to poor blood pressure (BP) control and pseudo-resistance (i.e. unawareness, life-style habits, non-adherence to medication, insufficient treatment, drug-induced hypertension, undiagnosed secondary causes etc.), it is reported that true resistant hypertension (RH) is found in 10.1 % of patients treated for elevated BP...
March 1, 2017: Pol Arch Intern Med
https://www.readbyqxmd.com/read/28266770/feasibility-of-catheter-ablation-renal-denervation-in-mild-resistant-hypertension
#12
Shaojie Chen, Marcio Galindo Kiuchi, Willem-Jan Acou, Michael Derndorfer, Jiazhi Wang, Ruotian Li, Georgios Kollias, Martin Martinek, Tetsuaki Kiuchi, Helmut Pürerfellner, Shaowen Liu
Renal denervation (RDN) has been proposed as a novel interventional antihypertensive technique. However, existing evidence was mainly from patients with severe resistant hypertension. The authors aimed to evaluate the efficacy of RDN in patients with resistant hypertension with mildly elevated blood pressure (BP). Studies of RDN in patients with mild resistant hypertension (systolic office BP 140-160 mm Hg despite treatment with three antihypertensive drugs including one diuretic, or mean systolic BP by 24-hour ambulatory BP measurement [ABPM] 135-150 mm Hg) were included...
March 7, 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28264922/impact-of-medication-adherence-on-the-effect-of-renal-denervation-the-sympathy-trial
#13
Rosa L de Jager, Esther de Beus, Martine M A Beeftink, Margreet F Sanders, Evert-Jan Vonken, Michiel Voskuil, Erik M van Maarseveen, Michiel L Bots, Peter J Blankestijn
Randomized trials of catheter-based renal denervation (RDN) as therapy for resistant hypertension showed conflicting results in blood pressure (BP) lowering effect. Adherence to medication is modest in this patient group and may importantly drive these conflicting results. SYMPATHY is a prospective open label multicenter trial in Dutch patients with resistant hypertension. Primary outcome was change in daytime systolic ambulatory BP at 6 months. Patients were randomly assigned to RDN on top of usual care. Adherence to BP lowering drugs was assessed at baseline and follow-up, using blood samples drawn synchronously with BP measurements...
April 2017: Hypertension
https://www.readbyqxmd.com/read/28258128/effects-of-renal-artery-denervation-on-ventricular-arrhythmias-in-a-postinfarct-model
#14
Nicholas Jackson, Sigfús Gizurarson, Mohammed Ali Azam, Benjamin King, Andrew Ramadeen, Nima Zamiri, Andreu Porta-Sánchez, Abdul Al-Hesayen, John Graham, Marjan Kusha, Stéphane Massé, Patrick F H Lai, John Parker, Rohan John, Tim-Rasmus Kiehl, Govind Krishna Kumar Nair, Paul Dorian, Kumaraswamy Nanthakumar
BACKGROUND: The therapeutic potential of renal denervation (RDN) for arrhythmias has not been fully explored. Detailed mechanistic evaluation is in order. The objective of the present study was to determine the antiarrhythmic potential of RDN in a postinfarct animal model and to determine whether any benefits relate to RDN-induced reduction of sympathetic effectors on the myocardium. METHODS AND RESULTS: Pigs implanted with single-chamber implantable cardioverter defibrillators to record ventricular arrhythmias (VAs) were subjected to percutaneous coronary occlusion to induce myocardial infarction...
March 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28255080/renal-denervation-therapy-for-the-treatment-of-arrhythmias-is-the-sky-the-limit
#15
EDITORIAL
Prashant D Bhave
No abstract text is available yet for this article.
March 2, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28255076/beneficial-effect-of-renal-denervation-on-ventricular-premature-complex-induced-cardiomyopathy
#16
Shinya Yamada, Li-Wei Lo, Yu-Hui Chou, Wei-Lun Lin, Shih-Lin Chang, Yenn-Jiang Lin, Shin-Huei Liu, Wen-Han Cheng, Tsung-Ying Tsai, Shih-Ann Chen
BACKGROUND: Frequent ventricular premature complexes (VPCs) can lead to the development of dilated cardiomyopathy and sudden cardiac death. Renal artery sympathetic denervation (RDN) may protect the heart from remodeling. This study aimed to investigate the effect of frequent VPCs on structural and electrical properties and whether RDN can protect the heart from remodeling. METHODS AND RESULTS: Eighteen rabbits were randomized to control (n=6), VPC (n=6), and VPC-RDN (n=6) groups...
March 2, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28246278/renal-denervation-in-the-acute-phase-of-ischemic-stroke-provides-brain-protection-in-hypertensive-rats
#17
Yu Hasegawa, Takashi Nakagawa, Kunihiko Matsui, Shokei Kim-Mitsuyama
BACKGROUND AND PURPOSE: Renal denervation (RD) may protect against cardiovascular diseases regardless of blood pressure (BP)-lowering effect. We hypothesized that RD can improve the outcome of acute ischemic stroke (AIS) in hypertensive rats. METHODS: An AIS model of spontaneously hypertensive stroke-prone rats (SHRSPs) was prepared by 90-minute middle cerebral artery occlusion followed by reperfusion. At 30 minutes poststroke, the SHRSPs were subjected to (1) sham operation or (2) RD to determine the beneficial effects of RD posttreatment...
February 28, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28243928/pathophysiology-and-potential-non-pharmacologic-treatments-of-obesity-or-kidney-disease-associated-refractory-hypertension
#18
REVIEW
Thierry H Le Jemtel, William Richardson, Rohan Samson, Abhishek Jaiswal, Suzanne Oparil
PURPOSE OF REVIEW: The review assesses the role of non-pharmacologic therapy for obesity and chronic kidney disease (CKD) associated refractory hypertension (rf HTN). RECENT FINDINGS: Hypertensive patients with markedly heightened sympathetic nervous system (SNS) activity are prone to develop refractory hypertension (rfHTN). Patients with obesity and chronic kidney disease (CKD)-associated HTN have particularly heightened SNS activity and are at high risk of rfHTN...
February 2017: Current Hypertension Reports
https://www.readbyqxmd.com/read/28236019/erratum-to-blood-pressure-response-to-catheter-based-renal-sympathetic-denervation-in-severe-resistant-hypertension-data-from-the-greek-renal-denervation-registry
#19
C Tsioufis, A Ziakas, K Dimitriadis, P Davlouros, M Marketou, A Kasiakogias, C Thomopoulos, D Petroglou, D Tsiachris, M Doumas, E Skalidis, C Karvounis, D Alexopoulos, P Vardas, I Kallikazaros, C Stefanadis, V Papademetriou, D Tousoulis
No abstract text is available yet for this article.
February 24, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28228942/effects-of-renal-denervation-on-vascular-remodelling-in-patients-with-heart-failure-and-preserved-ejection-fraction-a-randomised-control-trial
#20
Hitesh C Patel, Carl Hayward, Jennifer Keegan, Peter D Gatehouse, Ronak Rajani, Rajdeep S Khattar, Raad H Mohiaddin, Stuart D Rosen, Alexander R Lyon, Carlo di Mario
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)...
January 2017: JRSM Cardiovascular Disease
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