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https://www.readbyqxmd.com/read/29287767/resistant-hypertension-renal-denervation-or-intensified-medical-treatment
#1
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
https://www.readbyqxmd.com/read/29279521/influence-of-renal-sympathetic-denervation-in-patients-with-early-stage-heart-failure-versus-late-stage-heart-failure
#2
Jie Geng, Chun Chen, Xiujuan Zhou, Weichong Qian, Qijun Shan
Renal sympathetic denervation (RDN) is currently being investigated in multiple studies of heart failure (HF). Our aim was to assess the safety and effectiveness of RDN in patients with HF, and determine which patients could achieve more beneficial effects of RDN. A total of 17 consecutive patients with HF were enrolled in the study. Clinical symptoms, office blood pressure, and laboratory results were obtained and echocardiography was performed before and 12 months after RDN. Changes from baseline to 12 months were analyzed for all patients and for two subgroups based on HF duration (group 1: HF duration ≤ 3 years, n = 9; group 2: HF duration > 3 years, n = 8)...
December 27, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29235746/clinical-problem-solving-a-tobacco-merchant-who-can-t-spit
#3
Sandra Benizri, Nancy Agmon-Levin, Noam D Kitrey, Dan Carter, Elinor Goshen, Yehonathan Sharabi
A 47 year old man presented with a combination of dry mouth and lightheadedness while standing. His medical background was unremarkable except for cigarette smoking and hyperlipidemia. Sjögren's syndrome was ruled out, and he was referred for evaluation of orthostatic hypotension, which by then included syncopal episodes and injuries. Additional symptoms included dry eyes, constipation, reduced sweating, and erectile dysfunction. After excluding medications and structural cardiac abnormalities as causes of orthostatic hypotension, a clinical autonomic evaluation was performed...
December 2017: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29230587/arterial-wall-hypertrophy-is-ameliorated-by-%C3%AE-2-adrenergic-receptor-antagonist-or-aliskiren-in-kidneys-of-angiotensinogen-knockout-mice
#4
Haruka Nakamori, Shin-Ichiro Yoshida, Hiroaki Ishiguro, Shota Suzuki, Hiroaki Yasuzaki, Tatsuo Hashimoto, Tomoaki Ishigami, Nobuhito Hirawa, Yoshiyuki Toya, Satoshi Umemura, Kouichi Tamura
BACKGROUND: Arterial hypertrophy and interstitial fibrosis are important characteristics in kidneys of angiotensinogen-knockout (Atg -/-) mice. In these mice, which exhibit polyuria and hypotension, sympathetic nerve signaling is estimated to be compensatorily hyperactive. Furthermore, transforming growth factor (TGF)-β1 is overexpressed in mice kidneys. To determine whether sympathetic nerve signaling and TGF-β1 exacerbate arterial hypertrophy and interstitial fibrosis, intervention studies of such signaling are required...
December 11, 2017: Clinical and Experimental Nephrology
https://www.readbyqxmd.com/read/29228369/nicotine-gum-as-a-therapeutic-approach-for-low-blood-pressure-in-parkinson-s-disease-a-randomized-pilot-study
#5
Joanne DiFrancisco-Donoghue, Min-Kyung Jung, Adena Leder
Introduction: One cause for low blood pressure (BP) in Parkinson's disease (PD) is denervation of the sympathetic nervous system and reduced levels of norepinephrine. Nicotine increases heart rate and BP acutely by causing sympathetic stimulation. The absorption rate of nicotine gum is relatively quick and is absorbed at a constant rate. Our objective was to evaluate how nicotine gum affects acute low BP in PD. Methods: Ten subjects (age 69.3±8.8) completed this double blind, placebo controlled, cross-over design trial using nicotine gum (4 mg) and placebo gum on two separate days...
December 1, 2017: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
https://www.readbyqxmd.com/read/29225807/renal-denervation-using-carbon-dioxide-renal-angiography-in-patients-with-uncontrolled-hypertension-and-moderate-to-severe-chronic-kidney-disease
#6
Mohammed Awais Hameed, Jonathan S Freedman, Richard Watkin, Arul Ganeshan, Indranil Dasgupta
Background: Chronic kidney disease (CKD) is the most common cause of secondary hypertension. More than half of the patients have uncontrolled hypertension (≥140/90 mmHg on three or more antihypertensive agents at optimum doses). Renal sympathetic denervation (RSDN) has been shown to reduce blood pressure (BP) in patients with resistant hypertension. Although patients with CKD have high sympathetic drive, all major clinical trials have excluded patients with estimated glomerular filtration rates (eGFRs) <45 mL/min/1...
December 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29224639/a-multinational-clinical-approach-to-assessing-the-effectiveness-of-catheter-based-ultrasound-renal-denervation-the-radiance-htn-and-require-clinical-study-designs
#7
RANDOMIZED CONTROLLED TRIAL
Laura Mauri, Kazuomi Kario, Jan Basile, Joost Daemen, Justin Davies, Ajay J Kirtane, Felix Mahfoud, Roland E Schmieder, Michael Weber, Shinsuke Nanto, Michel Azizi
Catheter-based renal denervation is a new approach to treat hypertension via modulation of the renal sympathetic nerves. Although nonrandomized and small, open-label randomized studies resulted in significant reductions in office blood pressure 6months after renal denervation with monopolar radiofrequency catheters, the first prospective, randomized, sham-controlled study (Symplicity HTN-3) failed to meet its blood pressure efficacy end point. New clinical trials with new catheters have since been designed to address the limitations of earlier studies...
January 2018: American Heart Journal
https://www.readbyqxmd.com/read/29221324/the-role-of-sympathectomy-in-long-qt-syndrome
#8
REVIEW
Achilleas Antonopoulos, David Lawrence, Davide Patrini, Marco Scarci, Robert George, Martin Hayward, Sofoklis Mitsos, Nikolaos Panagiotopoulos
Long QT syndrome (LQTS) is an uncommon and potentially fatal cardiac channelopathy. Treatment options can be medical with β-blockers or surgical with implantable cardioverter defibrillator (ICD) implantations and left cardiac sympathetic denervation (LCSD). Purpose of this paper is through a literature review to identify the management algorithm and the role of sympathectomy in LQTS.
September 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29210862/renal-sympathetic-denervation-in-sweden-a-report-from-the-swedish-registry-for-renal-denervation
#9
Sebastian Völz, Jonas Spaak, Johan Elf, Christina Jägrén, Christer Lundin, Anna Stenborg, Jonas Andersson, Bengt Rundqvist, Thomas Kahan, Bert Andersson
BACKGROUND: Renal denervation (RDN) is a catheter-based intervention to treat patients with resistant hypertension. The biological effects of RDN are not fully understood, and randomized controlled trials have generated conflicting evidence. This report presents data from the Swedish Registry for Renal Denervation, an investigator-driven nationwide registry. PURPOSE: To assess the safety and efficacy of RDN on patients with resistant hypertension in a real-world clinical setting...
January 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/29202826/autonomic-nervous-system-involvement-in-pulmonary-arterial-hypertension
#10
REVIEW
Mylène Vaillancourt, Pamela Chia, Shervin Sarji, Jason Nguyen, Nir Hoftman, Gregoire Ruffenach, Mansoureh Eghbali, Aman Mahajan, Soban Umar
Pulmonary arterial hypertension (PAH) is a chronic pulmonary vascular disease characterized by increased pulmonary vascular resistance (PVR) leading to right ventricular (RV) failure. Autonomic nervous system involvement in the pathogenesis of PAH has been demonstrated several years ago, however the extent of this involvement is not fully understood. PAH is associated with increased sympathetic nervous system (SNS) activation, decreased heart rate variability, and presence of cardiac arrhythmias. There is also evidence for increased renin-angiotensin-aldosterone system (RAAS) activation in PAH patients associated with clinical worsening...
December 4, 2017: Respiratory Research
https://www.readbyqxmd.com/read/29194288/area-at-risk-can-be-assessed-by-iodine-123-meta-iodobenzylguanidine-single-photon-emission-computed-tomography-after-myocardial-infarction-a-prospective-study
#11
Christophe Hedon, Fabien Huet, Fayçal Ben Bouallegue, Hélène Vernhet, Jean-Christophe Macia, Thien-Tri Cung, Florence Leclercq, Stéphane Cade, Frédéric Cransac, Benoit Lattuca, D'Arcy Vandenberghe, Aurélie Bourdon, Meriem Benkiran, Fabien Vauchot, Richard Gervasoni, Emmanuel D'estanque, Denis Mariano-Goulart, François Roubille
BACKGROUND: Myocardial salvage is an important surrogate endpoint to estimate the impact of treatments in patients with ST-segment elevation myocardial infarction (STEMI). AIM: The aim of this study was to evaluate the correlation between cardiac sympathetic denervation area assessed by single-photon emission computed tomography (SPECT) using iodine-123-meta-iodobenzylguanidine (I-MIBG) and myocardial area at risk (AAR) assessed by cardiac magnetic resonance (CMR) (gold standard)...
November 29, 2017: Nuclear Medicine Communications
https://www.readbyqxmd.com/read/29186414/local-sympathetic-denervation-attenuates-myocardial-inflammation-and-improves-cardiac-function-after-myocardial-infarction-in-mice
#12
Karin A Ziegler, Andrea Ahles, Timo Wille, Julia Kerler, Deepak Ramanujam, Stefan Engelhardt
Aims: Cardiac inflammation has been suggested to be regulated by the sympathetic nervous system (SNS). However, due to the lack of methodology to surgically eliminate the myocardial SNS in mice, neuronal control of cardiac inflammation remains ill defined. Here, we report a procedure for local cardiac sympathetic denervation in mice and tested its effect in a mouse model of heart failure post myocardial infarction. Methods and Results: Upon preparation of the carotid bifurcation the right and left superior cervical ganglion were localized and their pre- and postganglionic branches dissected before removal of the ganglion...
November 24, 2017: Cardiovascular Research
https://www.readbyqxmd.com/read/29172730/renal-sympathetic-denervation-lowers-arterial-pressure-in-canines-with-obesity-induced-hypertension-by-regulating-gad65-and-at1r-expression-in-rostral-ventrolateral-medulla
#13
Zhijie Shen, Chunyan Weng, Zhihui Zhang, Xiaoyan Wang, Kan Yang
To explore the roles of glutamate acid decarboxylase 65 (GAD65) and angiotensin II type 1 receptor (AT1R) in the action of renal sympathetic denervation (RSD) on obesity-induced hypertension in canines. Thirty-two beagles were randomly divided into a hypertensive model (n = 22) and control (n = 10) groups. A hypertensive canine model was established by feeding a high-fat diet. Twenty hypertensive beagles were randomized equally to a sham-surgery and RSD-treated group receiving catheter-based radiofrequency RSD...
November 27, 2017: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/29162745/does-sympathetic-dysfunction-occur-before-denervation-in-pure-autonomic-failure
#14
Ling Guo, Murray D Esler, Carolina Sari, Sarah Phillips, Elisabeth A Lambert, Nora E Straznicky, Gavin W Lambert, Susan J Corcoran
BACKGROUND: Pure autonomic failure (PAF) is a rare sporadic disorder characterised by autonomic failure in the absence of a movement disorder or dementia and is associated with very low plasma norepinephrine levels - suggesting widespread sympathetic denervation, however the underlying pathology remains poorly elucidated. We sought to correlate clinical and neurochemical findings with sympathetic nerve protein abundances, accessed by way of a forearm vein biopsy, in patients with PAF and in healthy controls and patients with multiple systems atrophy (MSA) in whom sympathetic nerves are considered intact...
November 21, 2017: Clinical Science (1979-)
https://www.readbyqxmd.com/read/29162649/effects-of-sympathectomy-on-ovarian-follicular-development-and-steroid-secretion
#15
Maritza Paola Garrido, Daniela Fernandois, Mauricio Venegas, Alfonso Paredes
Recently, the influence of adrenergic activity over ovarian function, and thus fertility, has begun to gain importance. Previous studies have shown that adrenergic activity through norepinephrine (NE) participates in the control of follicular development and steroidal secretion from the ovary, among other functions. To examine this phenomenon, the denervation of the gonad has been widely used to observe changes in the ovary's performance. Nevertheless, the effect of the absence of adrenergic nerves in the ovary has only been studied in short times periods...
November 21, 2017: Reproduction: the Official Journal of the Society for the Study of Fertility
https://www.readbyqxmd.com/read/29147666/sympathetic-denervation-accelerates-wound-contraction-but-inhibits-reepithelialization-and-pericyte-proliferation-in-diabetic-mice
#16
Zhifang Zheng, Yu Wan, Yishu Liu, Yu Yang, Jianbing Tang, Wenhua Huang, Biao Cheng
Previous studies focused on the effects of sympathetic denervation with 6-hydroxydopamine (6-OHDA) on nondiabetic wounds, but the effects of 6-OHDA on diabetic wounds have not been previously reported. In this study, treated mice received intraperitoneal 6-OHDA, and control mice received intraperitoneal injections of normal saline. Full-thickness wounds were established on the backs of mice. The wounds were sectioned (four mice per group) for analysis at 2, 5, 7, 10, 14, 17, and 21 days after injury. The wound areas in the control group were larger than those in the treatment group...
2017: Journal of Diabetes Research
https://www.readbyqxmd.com/read/29137090/diabetic-and-sympathetic-influences-on-the-water-permeability-barrier-function-of-human-skin-as-measured-using-transepidermal-water-loss-a-case-control-study
#17
Seung Hoon Han, Ji Woong Park
The presence of long-standing hyperglycemic conditions has been suggested to lead to many skin problems associated with an impaired skin barrier function. However, the relationship between impaired skin barrier status and altered peripheral nervous system function has not yet been determined. The purpose of this study was to investigate the water evaporation rate as a measure of the permeability barrier function of diabetic skin and its relationship to diabetic sensorimotor polyneuropathy (DSPN) and peripheral autonomic neuropathy (PAN) using well-controlled confounding variables...
November 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29104628/renal-sympathetic-denervation-improves-myocardial-apoptosis-in-rats-with-isoproterenol-induced-heart-failure-by-downregulation-of-tumor-necrosis-factor-%C3%AE-and-nuclear-factor-%C3%AE%C2%BAb
#18
Wei Yao, Neng Wang, Jin Qian, Lu Bai, Xiaoxin Zheng, Guo Hou, Xuan Qiu, Bo Yang
Chronic congestive heart failure (CHF) is the end outcome of organic heart diseases and one of the major diseases harmful to human health. Renal sympathetic denervation (RSD) is the anatomical basis of transcatheter renal sympathetic nerve ablation within the renal artery. To date, the roles of norepinephrine and angiotensin II (Ang II) in myocardial apoptosis and their underlying mechanisms have not been well explored. The aim of the present study was to verify the hypothesis that RSD is likely to inhibit myocardial apoptosis by inhibiting the release of norepinephrine and Ang II...
November 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/29101167/transient-denervation-of-viable-myocardium-after-myocardial-infarction-does-not-alter-arrhythmia-susceptibility
#19
Diana C Parrish, Samantha D Francis Stuart, Antoinette Olivas, Lianguo Wang, Anders Nykjaer, Crystal May Ripplinger, Beth Ann Habecker
Cardiac sympathetic nerves stimulate heart rate and force of contraction. Myocardial infarction (MI) leads to the loss of sympathetic nerves within the heart, and clinical studies indicate that sympathetic denervation is a risk factor for arrhythmias and cardiac arrest. Two distinct types of denervation have been identified in the mouse heart after MI caused by ischemia-reperfusion: transient denervation of peri-infarct myocardium, and sustained denervation of the infarct. Sustained denervation is linked to increased arrhythmia risk, but it is not known if acute nerve loss in peri-infarct myocardium also contributes to arrhythmia risk...
November 3, 2017: American Journal of Physiology. Heart and Circulatory Physiology
https://www.readbyqxmd.com/read/29089334/ibat-sympathetic-innervation-is-not-required-for-body-weight-loss-induced-by-central-leptin-delivery
#20
Isabelle Cote, Yasemin Sakarya, Sara M Green, Drake Morgan, Christy S Carter, Nihal Tumer, Philip J Scarpace
We evaluated the contribution of brown adipose tissue (BAT) sympathetic innervation on central leptin mediated weight loss. In a short and long-term study, F344BN rats submitted to either a denervation of interscapular BAT (Denervated) or a sham operation (Sham). Animals from each group received Ob (Leptin) or GFP (Control) gene through a single injection of recombinant adeno-associated virus delivered centrally. Changes in body weight were recorded for 14 or 35 days, after which adipose tissues and skeletal muscles were weighed...
October 31, 2017: American Journal of Physiology. Endocrinology and Metabolism
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