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Renal sympathetic denervation

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https://www.readbyqxmd.com/read/29895590/attenuation-of-splanchnic-autotransfusion-following-noninvasive-ultrasound-renal-denervation-a-novel-marker-of-procedural-success
#1
Manish Saxena, Tariq Shour, Mussadiq Shah, Christopher B Wolff, Peter O O Julu, Vikas Kapil, David J Collier, Fu Liang Ng, Ajay Gupta, Armida Balawon, Jane Pheby, Anne Zak, Gurvinder Rull, Benjamin O'Brien, Roland E Schmieder, Melvin D Lobo
BACKGROUND: Renal denervation has no validated marker of procedural success. We hypothesized that successful renal denervation would reduce renal sympathetic nerve signaling demonstrated by attenuation of α-1-adrenoceptor-mediated autotransfusion during the Valsalva maneuver. METHODS AND RESULTS: In this substudy of the Wave IV Study: Phase II Randomized Sham Controlled Study of Renal Denervation for Subjects With Uncontrolled Hypertension, we enrolled 23 subjects with resistant hypertension...
June 12, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29873513/sodium-intake-but-not-renal-nerves-attenuates-renal-venous-pressure-induced-changes-in-renal-hemodynamics-in-rats
#2
Xiaohua Huang, Shereen M Hamza, Wenqing Zhuang, William A Cupples, Branko Braam
Increased central venous pressure and renal venous pressure (RVP) is associated with worsening of renal function in acute exacerbation of congestive heart failure. We tested whether an acute, isolated elevation of RVP in one kidney leads to ipsilateral renal vasoconstriction and decreased GFR and whether this depends on dietary salt intake or activation of renal nerves. Male Lewis rats received a normal (1% NaCl, NS) or high salt diet (6% NaCl, HS) for {greater than or equal to}14 days before the acute experiment...
June 6, 2018: American Journal of Physiology. Renal Physiology
https://www.readbyqxmd.com/read/29847164/bilateral-renal-cryo-denervation-decreases-arterial-pressure-and-improves-insulin-sensitivity-in-fructose-fed-sprague-dawley-rats
#3
Tyler Soncrant, Dragana Komnenov, William H Beierwaltes, Haiping Chen, Min Wu, Noreen F Rossi
Consumption of food high in fructose is prevalent in modern diets. One week of moderately high fructose combined with high salt diet was shown to increase blood pressure and failed to suppress plasma renin activity (PRA). We tested the hypothesis that the hypertension and high PRA are consequences of elevated renal sympathetic nerve activity (RSNA). In Protocol 1, we assessed RSNA by telemetry in conscious Sprague Dawley rats given 20% fructose or 20% glucose in drinking water on a 0.4% NaCl diet (NS) for one week then transitioned to a 4% (HS) NaCl diet...
May 30, 2018: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/29845330/changes-in-arterial-pressure-hemodynamics-in-response-to-renal-nerve-stimulation-both-before-and-after-renal-denervation
#4
Annemiek F Hoogerwaard, Ahmet Adiyaman, Mark R de Jong, Jaap Jan J Smit, Peter Paul H M Delnoy, Jan-Evert Heeg, Boudewijn A A M van Hasselt, Anand R Ramdat Misier, Michiel Rienstra, Arif Elvan
BACKGROUND: Renal nerve denervation (RDN) is developed as a potential treatment for hypertension. Recently, we reported the use of renal nerve stimulation (RNS) to localize sympathetic nerve tissue for subsequent selective RDN. The effects of RNS on arterial pressure dynamics remain unknown. The current study aimed to describe the acute changes in arterial pressure dynamics response to RNS before and after RDN. METHODS AND RESULTS: Twenty six patients with drug-resistant hypertension referred for RDN were included...
May 29, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29787310/decreased-expression-of-na-h-exchanger-isoforms-1-and-3-in-denervated-spontaneously-hypertensive-rat-kidney
#5
Jianling Li, Qiaoling He, Qingjie Li, Rongjie Huang, Xiaoyan Wei, Xiaofeng Pan, Weifeng Wu
To determine whether the sympathetic nerve plays a role in the regulation of Na+ -H+ exchange (NHE) in the kidney of spontaneously hypertensive rats (SHR), we investigated the expression of NHE and NHE regulatory protein family (NHERF) in the denervated kidneys compared with intact kidneys. Twelve-week-old male SHR and age-matched Wistar Kyoto (WKY) rats were used. SHR were randomly assigned to the renal denervated (RDNX, n = 8) or Sham (n = 8) groups. The protein and mRNA expression of NHE1, NHE3, NHERF1 and NHERF2 were assessed in the kidney of the groups...
May 22, 2018: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/29772927/design-and-simulation-of-novel-laparoscopic-renal-denervation-system-a-feasibility-study
#6
Eunbi Ye, Jinhwan Baik, Seunghyun Lee, Seon Young Ryu, Sunchoel Yang, Eue-Keun Choi, Won Hoon Song, Hyeong Dong Yuk, Chang Wook Jeong, Sung-Min Park
PURPOSE: In this study, we propose a novel laparoscopy-based renal denervation (RDN) system for treating patients with resistant hypertension. In this feasibility study, we investigated whether our proposed surgical instrument can ablate renal nerves from outside of the renal artery safely and effectively and can overcome the depth-related limitations of the previous catheter-based system with less damage to the arterial walls. METHOD: We designed a looped bipolar electrosurgical instrument to be used with laparoscopy-based RDN system...
May 18, 2018: International Journal of Hyperthermia
https://www.readbyqxmd.com/read/29765015/reduction-of-blood-pressure-following-after-renal-artery-adventitia-stripping-during-total-nephroureterectomy-potential-effect-of-renal-sympathetic-denervation
#7
Keisuke Okamura, Shunsuke Satou, Keita Setojima, Shinjiro Shono, Shigero Miyajima, Tatsu Ishii, Kazuyuki Shirai, Hidenori Urata
BACKGROUND Catheter-based renal sympathetic denervation has been reported to be effective for treatment resistance hypertension in Australia and Europe. However, in the blinded SYMPLICITY HTN-3 trial, renal denervation did not achieve a significant decrease in blood pressure (BP) in comparison to sham controls. There have been various discussions on the factors that influenced this result. CASE REPORT Two men on antihypertensive therapy underwent unilateral radical nephroureterectomy for cancer of the renal pelvis...
May 16, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29760664/reduced-renal-mass-salt-sensitive-hypertension-is-resistant-to-renal-denervation
#8
Ionut Tudorancea, Thomas E Lohmeier, Barbara T Alexander, Dragos Pieptu, Dragomir N Serban, Radu Iliescu
Aim: Activation of the sympathetic nervous system is common in resistant hypertension (RHT) and also in chronic kidney disease (CKD), a prevalent condition among resistant hypertensives. However, renal nerve ablation lowers blood pressure (BP) only in some patients with RHT. The influence of loss of nephrons per se on the antihypertensive response to renal denervation (RDNx) is unclear and was the focus of this study. Methods: Systemic hemodynamics and sympathetically mediated low frequency oscillations of systolic BP were determined continuously from telemetrically acquired BP recordings in rats before and after surgical excision of ∼80% of renal mass and subsequent RDNx...
2018: Frontiers in Physiology
https://www.readbyqxmd.com/read/29744617/cardiac-magnetic-resonance-assessment-of-central-and-peripheral-vascular-function-in-patients-undergoing-renal-sympathetic-denervation-as-predictor-for-blood-pressure-response
#9
Karl Fengler, Karl-Philipp Rommel, Stephan Blazek, Maximilian Von Roeder, Christian Besler, Christian Lücke, Matthias Gutberlet, Jennifer Steeden, Michael Quail, Steffen Desch, Holger Thiele, Vivek Muthurangu, Philipp Lurz
BACKGROUND: Most trials regarding catheter-based renal sympathetic denervation (RDN) describe a proportion of patients without blood pressure response. Recently, we were able to show arterial stiffness, measured by invasive pulse wave velocity (IPWV), seems to be an excellent predictor for blood pressure response. However, given the invasiveness, IPWV is less suitable as a selection criterion for patients undergoing RDN. Consequently, we aimed to investigate the value of cardiac magnetic resonance (CMR) based measures of arterial stiffness in predicting the outcome of RDN compared to IPWV as reference...
May 9, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29739333/renal-denervation-improves-cardiac-function-by-attenuating-myocardiocyte-apoptosis-in-dogs-after-myocardial-infarction
#10
Li Wang, Lijun Song, Chao Li, Qiaoli Feng, Mengping Xu, Zhuqing Li, Chengzhi Lu
BACKGROUND: Myocardial apoptosis is important in the pathogenesis and progression of myocardial infarction-induced heart failure (MI-HF). Renal sympathetic denervation (RDN) has become a promising therapeutic strategy for the treatment of HF. Previous studies have shown that RDN could improve heart function Yao et al. (Exp Ther Med 14:4104-4110, 2017). However, whether and how RDN regulates myocardial apoptosis in MI-HF is unclear. This study sought to evaluate the effects of RDN on cardiac function and apoptosis-related gene expression in MI-HF dogs...
May 8, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29717380/selective-vs-global-renal-denervation-a-case-for-less-is-more
#11
REVIEW
Marat Fudim, Asher A Sobotka, Yue-Hui Yin, Joanne W Wang, Howard Levin, Murray Esler, Jie Wang, Paul A Sobotka
PURPOSE OF REVIEW: Review the renal nerve anatomy and physiology basics and explore the concept of global vs. selective renal denervation (RDN) to uncover some of the fundamental limitations of non-targeted renal nerve ablation and the potential superiority of selective RDN. RECENT FINDINGS: Recent trials testing the efficacy of RDN showed mixed results. Initial investigations targeted global RDN as a therapeutic goal. The repeat observation of heterogeneous response to RDN including non-responders with lack of a BP reduction, or even more unsettling, BP elevations after RDN has raised concern for the detrimental effects of unselective global RDN...
May 1, 2018: Current Hypertension Reports
https://www.readbyqxmd.com/read/29694249/olmesartan-combined-with-renal-denervation-reduces-blood-pressure-in-association-with-sympatho-inhibitory-and-aldosterone-reducing-effects-in-hypertensive-mice-with-chronic-kidney-disease
#12
Masaaki Nishihara, Ko Takesue, Yoshitaka Hirooka
BACKGROUND: Augmented sympathetic nerve activity (SNA) and renin-angiotensin-aldosterone system (RAAS) activity are involved in the pathogenesis of hypertension (HT) accompanied by chronic kidney disease (CKD). Oxidative stress in the hypothalamus increases SNA in HT. Administration of an angiotensin ΙΙ receptor blocker (olmesartan; OLM) or renal denervation (RDN) exerts an antihypertensive effect in HT with CKD; however, the precise mechanisms of the combination therapy are not fully elucidated...
April 25, 2018: Clinical and Experimental Hypertension: CHE
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
#13
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
#14
Karl Fengler, Karl-Philipp Rommel, Stephan Blazek, 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...
July 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/29651618/effect-of-renal-sympathetic-denervation-on-ventricular-and-neural-remodeling
#15
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
#16
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
#17
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...
May 2018: Atherosclerosis
https://www.readbyqxmd.com/read/29594117/erythrocyte-salt-sedimentation-assay-does-not-predict-response-to-renal-denervation
#18
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
#19
Michael Doumas, Konstantinos Stavropoulos, Konstantinos P Imprialos, Vasilios G Athyros, Asterios Karagiannis
No abstract text is available yet for this article.
April 2018: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/29556850/renal-nerve-stimulation-as-procedural-end-point-for-renal-sympathetic-denervation
#20
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
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