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Renal sympathetic denervation

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https://www.readbyqxmd.com/read/29657937/the-role-of-angiotensin-ii-infusion-on-the-baroreflex-sensitivity-and-renal-function-in-intact-and-bilateral-renal-denervation-rats
#1
Mohammad Karim Azadbakht, Jalal Hassanshahi, Mehdi Nematbakhsh
Background: The role of renin-angiotensin system (RAS) in communication between renal system and cardiovascular system is extremely important. Baroreflex sensitivity (BRS) index defines as heart rate (HR) alteration versus mean arterial pressure (MAP) change ratio . Sympathetic nerve is arm of the baroreflexes and any change in its activity will lead to change in the BRS. The role of angiotensin II (Ang II) infusion in systemic circulation accompanied with bilateral renal denervation (RDN) on BRS index and renal function was studied...
2018: Advanced Biomedical Research
https://www.readbyqxmd.com/read/29652730/predictors-for-profound-blood-pressure-response-in-patients-undergoing-renal-sympathetic-denervation
#2
Karl Fengler, Karl-Philipp Rommel, Blazek Stephan, Maximilian von Roeder, Christian Besler, Philipp Hartung, Steffen Desch, Holger Thiele, Philipp Lurz
BACKGROUND: Renal sympathetic denervation (RDN) as treatment for hypertension shows highly variable results. Although some patients do not show any blood pressure (BP) change and in most patients a BP reduction of at least 5 mmHg can be found, some show a reduction at least 20 mmHg. We sought to identify predictors for such a profound BP response. METHODS: Profound BP response was defined as drop of at least 20 mmHg in daytime systolic ambulatory BP measurement (ABPM) 3 months after catheter-based RDN...
April 12, 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/29651618/effect-of-renal-sympathetic-denervation-on-ventricular-and-neural-remodeling
#3
L Wang, G Wei, L Song, C Li, F Zhang, Y Yang, C Lu
BACKGROUND: This study assessed the therapeutic effects of renal sympathetic denervation (RDN) on post-myocardial infarction (MI) ventricular remodeling and sympathetic neural remodeling in dogs. The possible mechanisms and optimal time for treatment are discussed. METHODS: We randomly assigned 30 dogs to five groups: RDN 1 week before MI (RDN1w + MI; n = 6), RDN 1 week after MI (MI1w + RDN; n = 6), RDN 2 weeks after MI (MI2w + RDN; n = 6), control (N; n = 6), and MI (n = 6)...
April 12, 2018: Herz
https://www.readbyqxmd.com/read/29651418/role-of-the-sympathetic-nervous-system-and-its-modulation-in-renal-hypertension
#4
REVIEW
Yusuke Sata, Geoffrey A Head, Kate Denton, Clive N May, Markus P Schlaich
The kidneys are densely innervated with renal efferent and afferent nerves to communicate with the central nervous system. Innervation of major structural components of the kidneys, such as blood vessels, tubules, the pelvis, and glomeruli, forms a bidirectional neural network to relay sensory and sympathetic signals to and from the brain. Renal efferent nerves regulate renal blood flow, glomerular filtration rate, tubular reabsorption of sodium and water, as well as release of renin and prostaglandins, all of which contribute to cardiovascular and renal regulation...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29627741/effects-of-renal-sympathetic-denervation-on-myocardial-structure-function-and-perfusion-a-serial-cmr-study
#5
Sinny Delacroix, Ramesh G Chokka, Adam J Nelson, Dennis T Wong, Stephen Pederson, Joanne Nimmo, Adil Rajwani, Kerry Williams, Karen S Teo, Stephen G Worthley
BACKGROUND AND AIMS: Echocardiographic studies have shown improvements in cardiac indices associated with renal sympathetic denervation (RDN), however, the benefits on myocardial perfusion have never been assessed. This trial was designed to study the effects of RDN on myocardial perfusion using cardiac magnetic resonance (CMR) imaging. METHODS: A total of 14 patients with resistant hypertension were recruited for RDN and myocardial perfusion, alongside other CMR indices, was assessed at baseline and at 6 months...
March 10, 2018: Atherosclerosis
https://www.readbyqxmd.com/read/29594117/erythrocyte-salt-sedimentation-assay-does-not-predict-response-to-renal-denervation
#6
Oliver Vonend, Ole Martin, Lars C Rump, Patrick Kroepil, Johannes Stegbauer
Renal denervation (RDN) has recently been shown to be effective in patients without antihypertensive medication. However, about 30% of patients do not respond to RDN, and therefore, there exists a need to find predictors of response. Individuals are either salt-sensitive (SS) or non-salt-sensitive (NSS) in terms of their blood pressure (BP) regulation. The sympathetic nervous system can influence water and salt handling. RDN reduces sympathetic drive and has an impact on salt excretion. The present study was conducted to test the influence of salt sensitivity in terms of the BP reducing effect after RDN procedure...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29575573/renal-sympathetic-denervation-ashes-to-ashes-or-rebirth-from-the-ashes
#7
Michael Doumas, Konstantinos Stavropoulos, Konstantinos P Imprialos, Vasilios G Athyros, Asterios Karagiannis
No abstract text is available yet for this article.
March 25, 2018: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/29556850/renal-nerve-stimulation-as-procedural-end-point-for-renal-sympathetic-denervation
#8
REVIEW
Annemiek F Hoogerwaard, Mark R de Jong, Arif Elvan
PURPOSE OF REVIEW: Renal sympathetic denervation (RDN) as treatment option for hypertension has a strong rationale; however, variable effects on blood pressure (BP) have been reported ranging from non-response to marked reductions in BP. The absence of a procedural end point for RDN is one of the potential factors associated with the variable response. Studies have suggested the use of renal nerve stimulation (RNS) to adequately address this issue. This review aims to provide an overview of the clinical and experimental data available regarding the effects of RNS in the setting of RDN...
March 19, 2018: Current Hypertension Reports
https://www.readbyqxmd.com/read/29555535/anatomical-and-procedural-determinants-of-ambulatory-blood-pressure-lowering-following-catheter-based-renal-denervation-using-radiofrequency
#9
Lucas Lauder, Sebastian Ewen, Abraham R Tzafriri, Elazer R Edelman, Bodo Cremers, Saarraaken Kulenthiran, Christian Ukena, Dominik Linz, Ingrid Kindermann, Costas Tsioufis, Bruno Scheller, Michael Böhm, Felix Mahfoud
BACKGROUND/PURPOSE: Catheter-based renal sympathetic denervation (RDN) has been introduced to lower blood pressure (BP) and sympathetic activity in patients with uncontrolled hypertension with at best equivocal results. It has been postulated that anatomic and procedural elements introduce unaccounted variability and yet little is known of the impact of renal anatomy and procedural parameters on BP response to RDN. METHODS/MATERIALS: Anatomical parameters such as length and diameter were analyzed by quantitative vascular analysis and the prevalence of accessory renal arteries and renal artery disease were documented in 150 patients with resistant hypertension undergoing bilateral RDN using a mono-electrode radiofrequency catheter (Symplicity Flex, Medtronic)...
March 2, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/29524326/anaphylactic-hypotension-causes-renal-and-adrenal-sympathoexcitaion-and-induces-c-fos-in-the-hypothalamus-and-medulla-oblongata-anaphylaxis-affects-the-brain-and-activates-sympathetic-nerves
#10
Mamoru Tanida, Zhang Tao, Lingling Sun, Jie Song, Wei Yang, Yuichi Kuda, Yasutaka Kurata, Toshishige Shibamoto
NEW FINDINGS: What is the central question of this study? Whether anaphylaxis affects sympathetic outflows to the brown adipose tissue (BAT) and adrenal grand is not known. Moreover, it is unknown whether anaphylaxis affects some brain areas in association with sympathetic regulation. What is the main finding and its importance? We showed that sympathoexcitatory responses to anaphylaxis regionally occurred in the kidney and adrenal grand, but not in the thermogenesis-related BAT. Further, anaphylactic hypotension also caused increase in c-fos immunoreactivity in the hypothalamic and medullary areas...
March 10, 2018: Experimental Physiology
https://www.readbyqxmd.com/read/29520698/renal-sympathetic-denervation-restores-aortic-distensibility-in-patients-with-resistant-hypertension-data-from-a-multi-center-trial
#11
Lukas Stoiber, Felix Mahfoud, Seyedeh Mahsa Zamani, Tomas Lapinskas, Michael Böhm, Sebastian Ewen, Saarraaken Kulenthiran, Markus P Schlaich, Murray D Esler, Tommy Hammer, Knut Haakon Stensæth, Burkert Pieske, Stephan Dreysse, Eckart Fleck, Titus Kühne, Marcus Kelm, Philipp Stawowy, Sebastian Kelle
Renal sympathetic denervation (RDN) is under investigation as a treatment option in patients with resistant hypertension (RH). Determinants of arterial compliance may, however, help to predict the BP response to therapy. Aortic distensibility (AD) is a well-established parameter of aortic stiffness and can reliably be obtained by CMR. This analysis sought to investigate the effects of RDN on AD and to assess the predictive value of pre-treatment AD for BP changes. We analyzed data of 65 patients with RH included in a multicenter trial...
March 8, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29487995/treatment-of-atrial-fibrillation-in-patients-with-enhanced-sympathetic-tone-by-pulmonary-vein-isolation-or-pulmonary-vein-isolation-and-renal-artery-denervation-clinical-background-and-study-design-the-asaf-trial-ablation-of-sympathetic-atrial-fibrillation
#12
Mark R de Jong, Annemiek F Hoogerwaard, Ahmet Adiyaman, Jaap Jan J Smit, Anand R Ramdat Misier, Jan-Evert Heeg, Boudewijn A A M van Hasselt, Isabelle C Van Gelder, Harry J G M Crijns, Ignacio Fernández Lozano, Jorge E Toquero Ramos, F Javier Alzueta, Borja Ibañez, José M Rubio, Fernando Arribas, José M Porres Aracama, Josep Brugada, Lluís Mont, Arif Elvan
BACKGROUND: Hypertension is an important, modifiable risk factor for the development of atrial fibrillation (AF). Even after pulmonary vein isolation (PVI), 20-40% experience recurrent AF. Animal studies have shown that renal denervation (RDN) reduces AF inducibility. One clinical study with important limitations suggested that RDN additional to PVI could reduce recurrent AF. OBJECTIVE: The goal of this multicenter randomized controlled study is to investigate whether RDN added to PVI reduces AF recurrence...
February 27, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29465712/ambulatory-arterial-stiffness-index-as-a-predictor-of-blood-pressure-response-to-renal-denervation
#13
Yusuke Sata, Dagmara Hering, Geoffrey A Head, Antony S Walton, Karlheinz Peter, Petra Marusic, Jaqueline Duval, Rebecca Lee, Louise J Hammond, Elisabeth A Lambert, Gavin W Lambert, Murray D Esler, Markus P Schlaich
BACKGROUND: Renal denervation (RDN) can reduce blood pressure (BP) in patients with resistant hypertension, but less so in patients with isolated systolic hypertension. A possible explanation is that patients with stiffer arteries may have lesser neural contribution to their hypertension. METHOD: We hypothesized that arterial stiffness predicts the response to RDN. From ambulatory BP monitoring (ABPM), ambulatory arterial stiffness index (AASI) was calculated as 1 - the regression slope of DBP versus SBP...
February 20, 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/29454047/renal-perivascular-adipose-tissue-form-and-function
#14
Carolina Baraldi A Restini, Alex Ismail, Ramya K Kumar, Robert Burnett, Hannah Garver, Gregory D Fink, Stephanie W Watts
Renal sympathetic activity affects blood pressure in part by increasing renovascular resistance via release of norepinephrine (NE) from sympathetic nerves onto renal arteries. Here we test the idea that adipose tissue adjacent to renal blood vessels, i.e. renal perivascular adipose tissue (RPVAT), contains a pool of NE which can be released to alter renal vascular function. RPVAT was obtained from around the main renal artery/vein of the male Sprague Dawley rats. Thoracic aortic PVAT and mesenteric PVAT also were studied as brown-like and white fat comparators respectively...
February 14, 2018: Vascular Pharmacology
https://www.readbyqxmd.com/read/29440276/accurate-depth-of-radiofrequency-induced-lesions-in-renal-sympathetic-denervation-based-on-a-fine-histological-sectioning-approach-in-a-porcine-model
#15
Atsushi Sakaoka, Hisako Terao, Shintaro Nakamura, Hitomi Hagiwara, Toshihito Furukawa, Kiyoshi Matsumura, Kenichi Sakakura
BACKGROUND: Ablation lesion depth caused by radiofrequency-based renal denervation (RDN) was limited to <4 mm in previous animal studies, suggesting that radiofrequency-RDN cannot ablate a substantial percentage of renal sympathetic nerves. We aimed to define the true lesion depth achieved with radiofrequency-RDN using a fine sectioning method and to investigate biophysical parameters that could predict lesion depth. METHODS AND RESULTS: Radiofrequency was delivered to 87 sites in 14 renal arteries from 9 farm pigs at various ablation settings: 2, 4, 6, and 9 W for 60 seconds and 6 W for 120 seconds...
February 2018: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/29430580/devices-and-interventions-for-the-prevention-of-adverse-outcomes-of-tachycardia-on-heart-failure
#16
REVIEW
Jasneet Devgun, Yash B Jobanputra, Michael Arustamyan, Robert Chait, Waqas Ghumman
Heart failure (HF) is the leading cause of hospitalization in the USA. Despite advances in pharmacologic management, the incidence of HF is on the rise and survivability is persistently reduced. Sympathetic overdrive is implicated in the pathophysiology of HF, particularly HF with reduced ejection fraction (HFrEF). Tachycardia can be particularly deleterious and thus has spurred significant investigation to mitigate its effects. Various modalities including vagus nerve stimulation, baroreceptor activation therapy, spinal cord stimulation, renal sympathetic nerve denervation, left cardiac sympathetic denervation, and carotid body removal will be discussed...
February 12, 2018: Heart Failure Reviews
https://www.readbyqxmd.com/read/29429026/modulation-of-renal-sympathetic-innervation-recent-insights-beyond-blood-pressure-control
#17
REVIEW
Dominik Linz, Mathias Hohl, Adrian D Elliott, Dennis H Lau, Felix Mahfoud, Murray D Esler, Prashanthan Sanders, Michael Böhm
Renal afferent and efferent sympathetic nerves are involved in the regulation of blood pressure and have a pathophysiological role in hypertension. Additionally, several conditions that frequently coexist with hypertension, such as heart failure, obstructive sleep apnea, atrial fibrillation, renal dysfunction, and metabolic syndrome, demonstrate enhanced sympathetic activity. Renal denervation (RDN) is an approach to reduce renal and whole body sympathetic activation. Experimental models indicate that RDN has the potential to lower blood pressure and prevent cardio-renal remodeling in chronic diseases associated with enhanced sympathetic activation...
February 10, 2018: Clinical Autonomic Research: Official Journal of the Clinical Autonomic Research Society
https://www.readbyqxmd.com/read/29388357/airway-obstruction-produces-widespread-sympathoexcitation-role-of-hypoxia-carotid-chemoreceptors-and-nts-neurotransmission
#18
Caroline B Ferreira, Sergio L Cravo, Sean D Stocker
Obstructive sleep apnea (OSA) is the most common respiratory disturbance of sleep and is closely associated to cardiovascular diseases. In humans, apnea increases respiratory effort and elevates muscle sympathetic nerve activity (SNA), but the primary stimulus for the SNA activation has not been identified. We recently developed a model of apnea in rodents using acute airway obstruction. In this study, we employed this model to test whether the elevation in SNA was mediated by hypoxia, carotid chemoreceptors, or neurotransmission in the nucleus tractus solitarius (NTS)...
February 2018: Physiological Reports
https://www.readbyqxmd.com/read/29374335/renal-sympathetic-nerve-activity-after-catheter-based-renal-denervation
#19
Linn C Dobrowolski, Daan W Eeftinck Schattenkerk, C T Paul Krediet, Peter M Van Brussel, Liffert Vogt, Frederike J Bemelman, Jim A Reekers, Bert-Jan H Van Den Born, Hein J Verberne
BACKGROUND: Catheter-based renal sympathetic denervation (RDN) has been considered a potential treatment for therapy resistant hypertension (RHT). However, in a randomized placebo-controlled trial, RDN did not lead to a substantial blood pressure (BP) reduction. We hypothesized that variation in the reported RDN efficacy might be explained by incomplete nerve disruption as assessed by renal 123 I-meta-iodobenzylguanidine (123 I-mIBG) scintigraphy. METHODS: In 21 RHT patients (median age 60 years), we performed 123 I-mIBG scintigraphy before and 6 weeks after RDN...
January 26, 2018: EJNMMI Research
https://www.readbyqxmd.com/read/29287767/resistant-hypertension-renal-denervation-or-intensified-medical-treatment
#20
REVIEW
Alberto Morganti, Giuseppe Mancia
Resistant hypertension (RH) can be diagnosed if blood pressure (BP) is not controlled with the combination of three antihypertensive drugs, including a diuretic, all at effective doses. Patients affected by this condition exhibit a marked increase in the risk of cardiovascular and renal morbid and fatal events. They also exhibit an increased activity of the sympathetic nervous system which is likely to importantly contribute at the renal and other vascular levels to the hypertensive state. Almost 10years ago renal denervation (RDN) by radiofrequency thermal energy delivery to the walls of the renal arteries was proposed for the treatment of RH...
December 27, 2017: European Journal of Internal Medicine
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