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sympathetic denervation

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https://www.readbyqxmd.com/read/28531827/safety-and-performance-of-the-second-generation-enlightn%C3%A2-renal-denervation-system-in-patients-with-drug-resistant-uncontrolled-hypertension
#1
Stephen G Worthley, Gerard T Wilkins, Mark W Webster, Joseph K Montarello, Sinny Delacroix, Robert J Whitbourn, Roderic J Warren
BACKGROUND AND AIMS: Catheter-based renal denervation for the treatment of drug-resistant hypertension has been intensively investigated in recent years. To date, only limited data have been published using multi-electrode radiofrequency ablation systems that can deliver lesions with a pre-determined pattern. This study was designed to evaluate the safety and performance of the second generation EnligHTN™ Renal Denervation System. METHODS: This first-in-human, prospective, multi-center, non-randomized study included 39 patients (62% male, mean age 63 years, and mean baseline office blood pressure 174/93 mmHg) with drug-resistant hypertension...
May 3, 2017: Atherosclerosis
https://www.readbyqxmd.com/read/28515119/pulse-wave-velocity-predicts-response-to-renal-denervation-in-isolated-systolic-hypertension
#2
Karl Fengler, Karl-Philipp Rommel, Robert Hoellriegel, Stephan Blazek, Christian Besler, Steffen Desch, Gerhard Schuler, Axel Linke, Philipp Lurz
BACKGROUND: Renal sympathetic denervation seems to be less effective as a treatment for hypertension in patients with isolated systolic hypertension, a condition associated with elevated central arterial stiffness. Because isolated systolic hypertension can also be caused by wave reflection or increased cardiac output, a more differentiated approach might improve patient preselection for renal sympathetic denervation. We sought to evaluate the additional predictive value of invasive pulse wave velocity for response to renal sympathetic denervation in patients with combined versus isolated systolic hypertension...
May 17, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28510647/epicardial-cardioverter-defibrillator-implantation-in-a-4-month-old-infant-bridged-to-heart-transplantation
#3
Cristina Carro, Alberto Francesco Cereda, Giuseppe Annoni, Stefano Maria Marianeschi
Implantable cardioverter-defibrillator (ICD) is the gold standard therapy for the prevention of sudden cardiac death. Nevertheless, ICD placement in the paediatric population is still limited because of several technical difficulties. Several implantation techniques have been proposed but experience in infants with very low weight and less than 6 months is very limited. We herein describe a case of a minimally invasive ICD epicardial implantation in a 4-month-old infant weighing 5 kg. A diagnosis of arrhythmic cardiomyopathy with left ventricular non-compaction disease with ventricular tachycardia storms, QT prolongation and Wolff-Parkinson-White pattern was made...
May 16, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28507735/does-dysfunction-of-the-autonomic-nervous-system-affect-success-of-renal-denervation-in-reducing-blood-pressure
#4
Lisa Fricke, David Petroff, Steffen Desch, Philipp Lurz, Sebastian Reinhardt, Melanie Sonnabend, Joseph Classen, Petra Baum
OBJECTIVES: Renal denervation is an interventional approach aiming to reduce high blood pressure. Its efficacy is subject of controversial debate. We analyzed autonomic function in patients undergoing renal denervation to identify responders. METHODS: A total of 21 patients with treatment-resistant hypertension scheduled for renal denervation were included. Heart rate variability, pupillary function and sympathetic skin response were examined prior to intervention...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/28499718/family-amyloid-polyneuropathy-sympathetic-denervation-and-liver-transplantation
#5
Maria João Ferreira
No abstract text is available yet for this article.
May 9, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28498963/hypertension-in-kidney-transplantation-is-associated-with-an-early-renal-nerve-sprouting
#6
Alessandro Mauriello, Valentina Rovella, Filippo Borri, Lucia Anemona, Elena Giannini, Erica Giacobbi, Andrea Saggini, Giampiero Palmieri, Alessandro Anselmo, Pierluigi Bove, Gerry Melino, Guardini Valentina, Manfredi Tesauro, D'Urso Gabriele, Nicola Di Daniele
Background.: Normalization of arterial pressure occurs in just a few patients with hypertensive chronic kidney disease undergoing kidney transplantation. Hypertension in kidney transplant recipients may be related to multiple factors. We aimed to assess whether hypertension in kidney-transplanted patients may be linked to reinnervation of renal arteries of the transplanted kidney. Methods.: We investigated renal arteries innervation from native and transplanted kidneys in three patients 5 months, 2 years and 11 years after transplantation, respectively...
May 12, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28497431/effect-of-catheter-based-renal-denervation-on-left-ventricular-function-mass-and-un-twist-with-two-dimensional-speckle-tracking-echocardiography
#7
Lida Feyz, Bas M van Dalen, Marcel L Geleijnse, Nicolas M Van Mieghem, Ron T van Domburg, Joost Daemen
BACKGROUND: Speckle tracking echocardiography (STE) is an echocardiography modality that is able to measure left ventricular (LV) characteristics, including rotation, strain and strain rate. Strain measures myocardial fibre contraction and relaxation. This study aims to assess the effect of renal sympathetic denervation (RDN) on functional myocardial parameters, including STE, and to identify potential differences between responders and non-responders. METHODS: The study population consisted of 31 consecutive patients undergoing RDN in the context of treatment for resistant hypertension...
May 11, 2017: Journal of Echocardiography
https://www.readbyqxmd.com/read/28495840/nonlinearities-of-heart-rate-variability-in-animal-models-of-impaired-cardiac-control-contribution-of-different-time-scales
#8
Luiz Eduardo Virgilio Silva, Renata Maria Lataro, Jaci Airton Castania, Carlos Alberto Aguiar Silva, Helio C Salgado, Rubens Fazan, Alberto Porta
Heart rate variability (HRV) has been extensively explored by traditional linear approaches (e.g. spectral analysis). However, several studies have pointed to the presence of nonlinear features in HRV, suggesting that linear tools might fail to account for the complexity of the HRV dynamics. Even though the prevalent notion is that HRV is nonlinear, the actual presence of nonlinear features is rarely verified. In this study, the presence of nonlinear dynamics was checked as a function of time scales in three experimental models of rats with different impairment of the cardiac control, namely rats with heart failure (HF), spontaneously hypertensive rats (SHRs) and sinoaortic denervated (SAD) rats...
May 11, 2017: Journal of Applied Physiology
https://www.readbyqxmd.com/read/28495182/threats-to-internal-validity-in-renal-sympathetic-denervation-trials
#9
Eduardo Infante de Oliveira
No abstract text is available yet for this article.
May 8, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28490450/sedentary-conditions-and-enhanced-responses-to-gaba-in-the-rvlm-role-of-the-contralateral-rvlm
#10
Maryetta D Dombrowski, Patrick J Mueller
A sedentary lifestyle is a major risk factor for cardiovascular disease, and both conditions are associated with overactivity of the sympathetic nervous system. Ongoing discharge of sympathetic nerves is regulated by the rostral ventrolateral medulla (RVLM), which in turn is modulated by the primary excitatory and inhibitory neurotransmitters glutamate and γ-amino-butyric acid (GABA), respectively. We reported previously that sedentary conditions enhance GABAergic modulation of sympathoexcitation in the RVLM, despite overall increased sympathoexcitation...
May 10, 2017: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/28480523/improvement-in-health-related-quality-of-life-after-renal-sympathetic-denervation-in-real-world-hypertensive-patients-12-month-outcomes-in-the-global-symplicity-registry
#11
Ingrid Kindermann, Sonja Maria Wedegärtner, Felix Mahfoud, Joachim Weil, Nicole Brilakis, Julia Ukena, Sebastian Ewen, Dominik Linz, Martin Fahy, Giuseppe Mancia, Michael Böhm
Renal denervation has been shown to reduce blood pressure in patients with uncontrolled hypertension, but less is known about its impact on quality of life. This analysis evaluated 12-month blood pressure and quality of life outcomes in 934 patients from the Global SYMPLICITY Registry who completed the EuroQoL five-dimensions three-level questionnaire (EQ-5D-3L). At baseline, 32% of patients reported anxiety/depression and 48% reported pain/discomfort. At 12 months (n=496), office and 24-hour ambulatory systolic blood pressure were reduced by 13...
May 7, 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28479268/progression-of-myocardial-sympathetic-denervation-assessed-by-123-i-mibg-imaging-in-familial-amyloid-polyneuropathy-and-the-effect-of-liver-transplantation
#12
Maria da Conceição Azevedo Coutinho, Nuno Cortez-Dias, Guilhermina Cantinho, Isabel Conceição, Tatiana Guimarães, Gustavo Lima da Silva, Miguel Nobre Menezes, Ana Rita Francisco, Rui Plácido, Fausto J Pinto
INTRODUCTION: Familial amyloid polyneuropathy (FAP) is a rare disease caused by systemic deposition of amyloidogenic variants of the transthyretin (TTR) protein. The TTR-V30M mutation is caused by the substitution of valine by methionine at position 30 and mainly affects the peripheral and autonomic nervous systems. Cardiovascular manifestations are common and are due to autonomic denervation and to amyloid deposition in the heart. Cardiac sympathetic denervation detected by iodine-123 labeled metaiodobenzylguanidine (MIBG) is an important prognostic marker in TTR-V30M FAP...
May 4, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28474478/incomplete-cavernous-sinus-syndrome-as-the-initial-manifestation-of-a-previously-undetected-metastatic-prostate-adenocarcinoma
#13
María Machío Castelló, Diego Escobar Montatixe, Carlos Cenjor Español, José Miguel Villacampa Aubá, Julia Montoya Bordón, Rafael Carias Calix, Rafael Sáez Pinel
BACKGROUND: Cavernous sinus syndrome presents as unilateral ophthalmoplegia associated with sympathetic denervation, pain, paresthesias, and V1 and V2 distribution numbness. The etiology may be vascular, inflammatory, infectious, and, less commonly, neoplastic (metastatic). METHODS: We report a patient with incomplete cavernous sinus syndrome as the initial manifestation of previously undetected metastatic prostate adenocarcinoma. RESULTS: A 59-year-old man presented with a 2-month history of left hemicranial headaches with ptosis and binocular diplopia...
May 5, 2017: Head & Neck
https://www.readbyqxmd.com/read/28471068/stellate-ganglion-blockade-and-bilateral-cardiac-sympathetic-denervation-in-patients-with-life-threatening-ventricular-arrhythmias
#14
Ricardo Cardona-Guarache, Santosh K Padala, Luis Velazco-Davila, Anthony Cassano, Antonio Abbate, Kenneth A Ellenbogen, Jayanthi Koneru
Autonomic modulation is being increasingly employed as a strategy to treat ventricular arrhythmias refractory to beta-blockers, antiarrhythmic drugs and catheter-based ablation procedures. We report 6 patients with refractory ventricular tachycardia (VT) or ventricular fibrillation (VF) treated with stellate ganglion blockade (SGB) and/or bilateral cardiac sympathetic denervation (CSD). Our case series emphasizes the concept that the cardiac sympathetic nerves are important targets in the management of ventricular arrhythmias...
May 4, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28462715/clinical-value-of-measuring-the-renin-aldosterone-levels-optimising-the-management-of-uncontrolled-resistant-hypertension
#15
Michalis Doumas, Chrysoula Boutari, Costas Tsioufis, Kyriakos Dimitriadis, Areti Triantafyllou, Stella Douma
Resistant hypertension (HT) is a common clinical entity with debilitating cardiovascular consequences. The highly heterogeneous nature of resistant HT requires a meticulous work-up to exclude 'pseudo-resistance' and secondary forms of arterial HT. Resistant HT has recently gained wide scientific interest due to the introduction of interventional methods (renal sympathetic denervation and carotid baroreceptor stimulation) for blood pressure (BP) reduction in this patient population. Despite however the recent advances in understanding the pathophysiology and the clinical characteristics of the disease, the appropriate management of resistant HT remains elusive...
April 26, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28462714/renal-denervation-therapy-can-it-contribute-to-better-blood-pressure-control-in-hypertension
#16
Costas Tsioufis, Kyriakos Dimitriadis, Athanasios Kordalis, Michalis Doumas, Dimitris Konstantinidis, Theodoros Kalos, Felix Mahfoud, Vasilios Papademetriou, Dimitrios Tousoulis
Although the first results from studies suggested important benefits regarding blood pressure (BP) control in resistant hypertension by the use of diverse systems of renal denervation (RDN) in the setting of resistant hypertension, the Symplicity HTN-3, randomized sham-controlled trial reduced the enthusiasm and led to a more critical approach towards this neuromodulation innovative therapy. Nowadays there is an ongoing research attempt to justify the pathophysiological background of RDN since overdrive of the sympathetic nervous system is one of the key mechanisms leading to the development and progression of the hypertensive and cardiovascular diseases...
April 26, 2017: Current Vascular Pharmacology
https://www.readbyqxmd.com/read/28459715/biphasic-renal-sympathetic-response-to-hemorrhagic-hypotension-in-mice
#17
Tao Zhang, Mamoru Tanida, Kunitoshi Uchida, Yoshiro Suzuki, Wei Yang, Yuhichi Kuda, Yasutaka Kurata, Makoto Tominaga, Toshishige Shibamoto
AIM: The inhibitory responses of renal sympathetic nerve activity (RSNA) and heart rate (HR) to sustained hemorrhagic shock occurred in anesthetized rats, but have not yet been determined in mice. Here, we investigated the responses of RSNA and HR to hemorrhagic hypotension in anesthetized mice, with an emphasis on the molecule-based mechanism for roles of afferent vagal nerves. METHODS: RSNA, HR, and mean systemic arterial pressure (MAP) were continuously measured in male pentobarbital-anesthetized C57BL/6N mice...
April 28, 2017: Shock
https://www.readbyqxmd.com/read/28456548/changes-in-albumin-to-creatinine-ratio-at-12-month-follow-up-in-patients-undergoing-renal-denervation
#18
Henrique Sousa, Patrícia Branco, Manuel de Sousa Almeida, Pedro de Araújo Gonçalves, Augusta Gaspar, Hélder Dores, João Mesquita, Maria João Andrade, Nuno Neuparth, Ana Aleixo, Miguel Mendes, José Diogo Barata
INTRODUCTION: Sympathetic renal denervation (RDN) was developed as a treatment for the management of patients with resistant hypertension. This procedure may have a positive impact on hypertension-related target organ damage, particularly renal disease, but the evidence is still limited. OBJECTIVE: To assess the impact of RDN on the albumin-to-creatinine ratio (ACR) at 12-month follow-up. METHODS AND RESULTS: From a single-center prospective registry including 65 patients with resistant hypertension undergoing renal denervation, 31 patients with complete baseline and 12-month follow-up blood pressure (BP) measurements (both office and 24-h ambulatory blood pressure monitoring [ABPM]) and ACR were included in the present study...
April 26, 2017: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/28456134/improvement-in-baroreflex-control-of-renal-sympathetic-nerve-activity-in-obese-sprague-dawley-rats-following-immunosuppression
#19
Safia Akhtar Khan, Munavvar Zubaid Abdul Sattar, Nor Azizan Abdullah, Hassaan Anwer Rathore, Ashfaq Ahmad, Mohammed Hadi Abdulla, Edward James Johns
AIM: This investigation explored the hypothesis that in obesity an inflammatory response in the kidney contributed to a renal nerve-dependent blunting of the baroreflex regulation of renal sympathetic nerve activity. METHODS: Rats received a normal (12%Kcal) or high-fat (45%Kcal) diet for 8 weeks plus daily injections of vehicle (0.9% NaCl i.p) or tacrolimus (0.25mg kg(-1) day(-1) i.p) from weeks 3-8. Following anaesthesia, left renal sympathetic nerve activity was recorded, baroreflex gain curves were generated, by infusing phenylephrine and sodium nitroprusside, and cardiopulmonary baroreceptors challenged by infusing a saline load...
April 29, 2017: Acta Physiologica
https://www.readbyqxmd.com/read/28455809/renal-denervation-therapy-for-drug-resistant-hypertension-does-it-still-work
#20
REVIEW
Venkatesh K Raman, Costas Tsioufis, Michael Doumas, Vasilios Papademetriou
Hypertension is a global public health problem affecting one-fourth of the world's population. A subset of these patients with resistant hypertension presents a particular management problem and suffers a marked increase in cardiovascular risk. Treatment options have been limited, but the past decade has witnessed the emergence of catheter-based renal denervation to interrupt the sympathetic nervous system, long considered to play an important role in the development and maintenance of hypertension. Phase 1 and 2 studies reported remarkable reductions in blood pressure and sparked an excessive exuberance that ground to a halt with negative results of the SYMPLICITY HTN-3 pivotal trial...
May 2017: Current Treatment Options in Cardiovascular Medicine
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