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Renal sympathetic denervation

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https://www.readbyqxmd.com/read/27908698/potential-role-of-endurance-training-in-altering-renal-sympathetic-nerve-activity-in-ckd
#1
REVIEW
Erin J Howden, Justin S Lawley, Murray Esler, Benjamin D Levine
Chronic kidney disease (CKD), is characterized by a progressive loss of renal function and increase in cardiovascular risk. In this review paper, we discuss the pathophysiology of increased sympathetic nerve activity in CKD patients and raise the possibility of endurance exercise being an effective countermeasure to address this problem. We specifically focus on the potential role of endurance training in altering renal sympathetic nerve activity as increased renal sympathetic nerve activity negatively impacts kidney function as well indirectly effects multiple other systems and organs...
November 25, 2016: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/27906840/renal-artery-denervation-for-treatment-of-patients-with-self-reported-obstructive-sleep-apnea-and-resistant-hypertension-results-from-the-global-symplicity-registry
#2
Dominik Linz, Giuseppe Mancia, Felix Mahfoud, Krzysztof Narkiewicz, Luis Ruilope, Markus Schlaich, Ingrid Kindermann, Roland E Schmieder, Sebastian Ewen, Bryan Williams, Michael Böhm
BACKGROUND: Sleep-disordered breathing, predominantly obstructive sleep apnea (OSA), is highly prevalent in patients with hypertension. OSA may underlie the progression to resistant hypertension, partly due to increased activation of the sympathetic nervous system. This analysis of patients with and without OSA evaluated the blood pressure (BP)-lowering effect of sympathetic modulation by renal denervation (RDN) in a real-world setting. METHODS: The Global SYMPLICITY Registry (NCT01534299) is a prospective, open-label, multicenter registry conducted worldwide to evaluate the safety and effectiveness of RDN in patients with uncontrolled hypertension...
January 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/27905168/editorial-can-renal-denervation-work-yes-but-first-one-must-denervate-lessons-from-human-renal-sympathetic-nerve-anatomy
#3
EDITORIAL
Tim A Fischell
No abstract text is available yet for this article.
December 2016: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/27890860/renal-denervation-by-ct-guided-periarterial-injection-of-hyperosmolar-saline-vincristine-paclitaxel-and-guanethidine-in-a-pig-model
#4
Patrick Freyhardt, Ricardo Donners, Alex Riemert, Jörg Schnorr, Nicola Stolzenburg, Jan Leo Rinnenthal, Ulrich Bernhardt, Bernd Hamm, Rolf W Günther, Florian Streitparth
AIMS: To evaluate feasibility, safety and efficacy of renal sympathetic denervation with CT- guided periarterial injection of potentially neurolytic agents in pigs. METHODS AND RESULTS: Unilateral injection of formulations containing either 5 M hyperosmolar saline, vincristine, paclitaxel or guanethidine around the renal artery was performed in 24 normotensive pigs with 6 animals per group. Needle placement and injections were performed under CT-fluoroscopy guidance...
November 29, 2016: EuroIntervention
https://www.readbyqxmd.com/read/27890739/novel-insights-into-the-mechanisms-of-renal-sympathetic-denervation-induced-neuromodulation-in-controlling-atrial-arrhythmias-in-canines
#5
EDITORIAL
Annemiek F Hoogerwaard, Arif Elvan
No abstract text is available yet for this article.
November 23, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/27865077/renal-sympathetic-denervation-recalculating%C3%A2
#6
EDITORIAL
Jorge A Belardi, Mariano Albertal
No abstract text is available yet for this article.
November 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27849014/renal-artery-vasodilation-may-be-an-indicator-of-successful-sympathetic-nerve-damage-during-renal-denervation-procedure
#7
Weijie Chen, Huaan Du, Jiayi Lu, Zhiyu Ling, Yi Long, Yanping Xu, Peilin Xiao, Laxman Gyawali, Kamsang Woo, Yuehui Yin, Bernhard Zrenner
Autonomic nervous system plays a crucial role in maintaining and regulating vessel tension. Renal denervation (RDN) may induce renal artery vasodilation by damaging renal sympathetic fibers. We conducted this animal study to evaluate whether renal artery vasodilation could be a direct indicator of successful RDN. Twenty-eight Chinese Kunming dogs were randomly assigned into three groups and underwent RDN utilizing temperature-controlled catheter (group A, n = 11) or saline-irrigated catheter (group B, n = 11) or sham procedure (group C, n = 6)...
November 16, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27845300/effects-of-renal-sympathetic-denervation-on-cardiac-systolic-function-after-myocardial-infarction-in-rats
#8
Jiqun Guo, Zhongxia Zhou, Zhenzhen Li, Qian Liu, Guoqing Zhu, Qijun Shan
This study investigated the therapeutic effects of renal denervation on cardiac systolic function after myocardial infarction (MI) in rats and the mechanism involved. Fifty male SD rats were randomly assigned to the sham group (n = 15), the MI group (n = 20), and the MI plus renal denervation group (n = 15). MI was established through thoracotomic ligation of the anterior descending artery. Renal denervation was achieved by laparotomic stripping of the renal arterial adventitial sympathetic nerve, approximately 3 mm from the abdominal aorta...
September 2016: Journal of Biomedical Research
https://www.readbyqxmd.com/read/27815927/renal-denervation
#9
Mohammed Awais Hameed, Indranil Dasgupta
Sympathetic nervous system over-activity is closely linked with elevation of systemic blood pressure. Both animal and human studies suggest renal sympathetic nerves play an important role in this respect. Historically, modulation of sympathetic activity has been used to treat hypertension. More recently, catheter based renal sympathetic denervation was introduced for the management of treatment resistant hypertension. Sound physiological principles and surgical precedent underpin renal denervation as a therapy for treatment of resistant hypertension...
November 5, 2016: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/27775435/copeptin-resistant-hypertension-and-renal-sympathetic-denervation
#10
Marius Schwerg, Anna Slagman, Karl Stangl, Verena Stangl
BACKGROUND: Renal denervation is used as a treatment option for patients with resistant hypertension. But only a subgroup of patients benefits from RDN. Biomarkers might be helpful to identify patients who respond to RDN. Copeptin as a surrogate for vasopressin levels is increased in hypertension and other cardiovascular diseases. This study aims to evaluate the effect of RDN on Copeptin and its prognostic value for response to RDN. METHOD AND RESULTS: A total of 40 patients have been included in the study...
October 24, 2016: Biomarkers: Biochemical Indicators of Exposure, Response, and Susceptibility to Chemicals
https://www.readbyqxmd.com/read/27755390/renal-denervation-reduces-office-and-ambulatory-heart-rate-in-patients-with-uncontrolled-hypertension-12-month-outcomes-from-the-global-symplicity-registry
#11
Michael Böhm, Christian Ukena, Sebastian Ewen, Dominik Linz, Ina Zivanovic, Uta Hoppe, Krzysztof Narkiewicz, Luis Ruilope, Manuela Negoita, Roland Schmieder, Bryan Williams, Uwe Zeymer, Andreas Zirlik, Guiseppe Mancia, Felix Mahfoud
OBJECTIVES: Renal denervation (RDN) can reduce sympathetic activity and blood pressure (BP) in patients with hypertension. The effects on resting and ambulatory heart rate (HR), also regulated by the sympathetic nervous system, are not established. METHODS: Herein, we report 12-month outcomes from the Global SYMPLICITY Registry on office and ambulatory HR and BP in patients with uncontrolled hypertension (n = 846). RESULTS: HR declined in correlation with the HR at baseline and at 12 months, in particular, in patients in the upper tertile of HR (>74 bpm)...
October 15, 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754278/hw-03-1-renal-sympathetic-denervation-for-resistant-hypertension-under-optimal-drug-therapy
#12
Byeong-Keuk Kim
Catheter-based renal sympathetic denervation (RDN) has opened the new world in the treatment of resistant or refractory hypertension. However, SYMPLICITY HTN-3, 2:1 randomization, blinded and sham-controlled study did not show a significant reduction of systolic blood pressure (BP) in patients with resistant hypertension 6 months after RDN as compared with a sham control. After that, substudy investigating the predictors of BP responses in SYMPLICITY HTN-3 trial was reported; racial difference and optimal medical treatment were issued for the optimal denervation therapy...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754272/sy-17-2-inflammation-immunity-and-hypertension
#13
David Harrison
Hypertension remains an enormous health care burden that affects one third of the population. Despite its prevalence the cause of most cases of hypertension remains unknown. Our laboratory has defined a novel mechanism for hypertension involving adaptive immunity. We found that mice lacking lymphocytes (RAG-1 mice) develop blunted hypertensive responses to a variety of stimuli including chronic angiotensin II infusion, DOCA-salt challenge and norepinephrine infusion. Adoptive transfer of T cells, but not B cells, restores the hypertensive responses to these stimuli...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754182/db-03-2-renal-sympathetic-denervation-is-still-a-viable-option-for-treating-resistant-hypertension-con
#14
George Bakris
Renal denervation started out as a very promising approach to treat resistant hypertension with a very strong conceptual and basic science frame work from Gerald DiBona's lab and extending into the early non shame clinical studies demonstrating proof of concept in SYMPLICITY HTN-1 and 2. SYMPLICITY-HTN 3 a properly done, sham control trial failed to show a benefit on further reduction of BP compared to the sham group. The conclusion the procedure doesn't work. How could this be-it was clearly effective in animal models but why not in man...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754181/db-03-1-renal-sympathetic-denervation-is-still-a-viable-option-for-treating-resistant-hypertension-pro
#15
Markus Schlaich
Accumulating evidence from mainly uncontrolled and unblinded 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 most patients with treatment resistant hypertension. Sustained BP lowering has been documented up to 3 years at this stage. 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...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754154/os-29-06-response-to-hemorrhage-following-catheter-based-renal-denervation-in-sheep-with-hypertensive-kidney-disease
#16
Kate Denton, Karen Moritz, Lindsey Booth, Clive May, Geoff Head, Markus Schlaich, Reetu Singh
OBJECTIVE: Renal sympathetic nerves contribute significantly to the control of kidney function and blood pressure. A critical question is whether catheter-based renal denervation (cDNX) has adverse consequences, in situations of clinical challenge, such as hemorrhage. The aim was to examine the effects of cDNX on basal mean arterial pressure (MAP) and glomerular filtration rate (GFR) and in response to hemorrhage in hypertensive sheep with chronic kidney disease (CKD). DESIGN AND METHOD: Hypertension and CKD was induced in sheep by performing fetal unilateral nephrectomy (CKD; N = 14)...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754153/os-29-05-renal-denervation-attenuates-aldosterone-expression-and-associated-cardiovascular-pathophysiology-in-angiotensin-ii-induced-hypertension
#17
Xiaodong Li, Mona Hong, Dingliang Zhu, Pingjin Gao
OBJECTIVE: The sympathetic nervous system interacts with the renin-angiotensin-aldosterone system (RAAS) contributing to cardiovascular diseases. In this study, we sought to determine if renal denervation (RDN) inhibits aldosterone expression and associated cardiovascular pathophysiological changes in angiotensin II (Ang II)-induced hypertension. DESIGN AND METHOD: Bilateral RDN or SHAM operation was performed before chronic 14-day Ang II infusion (200 ng/kg/min) in male Sprague-Dawley rats...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754151/os-29-03-increased-neurokinin-release-from-afferent-renal-nerves-is-accompanied-by-decreased-afferent-electric-activity
#18
Tilmann Ditting, Kristina Rodionova, Sonja Heinlein, Karl Friedrich Hilgers, Christian Ott, Roland Schmieder, Kerstin Amann, Roland Veelken
OBJECTIVE: Afferent renal nerves exhibit a dual function. They influence intrarenal immunological processes by release of neurokinins like CGRP and control central sympathetic outflow via afferent electrical activity. The former seems to be important in renal inflammation whereas the sympathetic modulation by afferent electrical activity is not fully understood in cardiovascular disease and hypertension. Hence, we hypothesized that augmented effects of CGRP in renal inflammation occur with increased afferent renal nerve activity...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754145/os-28-03-secretory-capacity-of-pancreatic-beta-cells-is-enhanced-6-months-after-renal-denervation-in-treatment-resistant-hypertensive-patients
#19
Christian Ott, Iris Kistner, Axel Schmid, Stefanie Friedrich, Tilmann Ditting, Roland Veelken, Felix Mahfoud, Michael Böhm, Michael Uder, Roland Schmieder
OBJECTIVE: Renal denervation (RDN) lowers blood pressure (BP) by interruption of sympathetic nerve activity. A high sympathetic tone increases not only BP but also decreases pancreatic beta cell insulin secretion. Hence, the objective of the study was to analyze whether RDN improves secretory capacity of beta cells. DESIGN AND METHOD: In 40 patients (7 diabetics, 19 prediabetics, 14 non diabetics) with treatment resistant hypertension (defined by office BP ≥ 140/90 mmHg and diagnosis confirmed with 24-h ambulatory BP ≥ 130/80 mmHg), insulin secretion was measured before and 6 months after RDN (Simplicity flex catheter, Medtronic) by glucagon test...
September 2016: Journal of Hypertension
https://www.readbyqxmd.com/read/27754144/os-28-02-renal-denervation-alters-adipokine-levels-in-patients-with-resistant-hypertension
#20
Markus Schlaich, Dagmara Hering, Petra Marusic, Antony Walton, Elisabeth Lambert, Henry Krum, Gavin Lambert, Murray Esler, Nina Eikelis
OBJECTIVE: We have previously demonstrated the effectiveness of renal denervation (RDN) to lower blood pressure (BP) in part via the reduction of renal sympathetic activity. The aim of this study was to examine the effect of RDN on adipokines. In particular, whether BP reduction, associated with RDN treatment, has a favorable outcome on adipokine profile in patients with resistant hypertension (RH). DESIGN AND METHOD: Fifty seven patients with RH undergoing RDN have been recruited for the study (65% males, age 60...
September 2016: Journal of Hypertension
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