Cardiac magnetic resonance assessment of central and peripheral vascular function in patients undergoing renal sympathetic denervation as predictor for blood pressure response

Fengler, Karl; Rommel, Karl‐Philipp; Blazek, Stephan; Roeder, Maximilian von; Besler, Christian; Lücke, Christian; Gutberlet, Matthias; Steeden, Jennifer A.; Quail, Michael A.; Desch, Steffen; Thiele, Holger; Muthurangu, Vivek; Lurz, Philipp

doi:10.1007/s00392-018-1267-6

Cited by 15 publications

(18 citation statements)

References 134 publications

(98 reference statements)

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“…While previous research aimed to assess AD in vivo, newer studies focus on therapeutic concepts to reduce arterial stiffness [11][12][13][14]. Both medical control of heart rate and modulation of the sympathetic nervous system by renal denervation have shown promising results to improve AD.…”

Section: Discussionmentioning

confidence: 99%

“…Recently, two studies investigated AD measurement as a non-invasive tool to control the effect of renal denervation [4,11]. These studies included 58 and 28 patients, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…Previously, several authors have made significant contributions to assess aortic compliance with various imaging methods [5][6][7][8]. Measurements of AD can give information even on subclinical vascular changes and are being investigated as predictors of cardiovascular morbidity [4,[9][10][11]. Newer preclinical and clinical studies are focusing on mechanisms of influencing AD.…”

Section: Introductionmentioning

confidence: 99%

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Validation of simple measures of aortic distensibility based on standard 4-chamber cine CMR: a new approach for clinical studies

et al. 2019

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Objective Aortic distensibility (AD) represents a well-established parameter of aortic stiffness. It remains unclear, however, whether AD can be obtained with high reproducibility in standard 4-chamber cine CMR images of the descending aorta. This study investigated the intra-and inter-observer agreement of AD based on different angles of the aorta and provided a sample size calculation of AD for future trials. Methods Thirty-one patients underwent CMR. Angulation of the descending aorta was performed to obtain strictly transversal and orthogonal cross-sectional aortic areas. AD was obtained both area and diameter based. Results For area-based values, inter-observer agreement was highest for 4-chamber AD (ICC 0.97; 95% CI 0.93-99), followed by orthogonal AD (ICC 0.96; 95% CI 0.91-98) and transversal AD (ICC 0.93; 95% CI 0.80-97). For diameter-based values, agreement was also highest for 4-chamber AD (ICC 0.97; 95% CI 0.94-99), followed by orthogonal AD (ICC 0.96; 95% CI 0.92-98) and transversal AD (ICC 0.91; 95% CI 0.77-96). Bland-Altman plots confirmed a small variation among observers. Sample size calculation showed a sample size of 12 patients to detect a change in 4-chamber AD of 1 × 10 −3 mmHg −1 with either the area or diameter approach. Conclusion AD measurements are highly reproducible and allow an accurate and rapid assessment of arterial compliance from standard 4-chamber cine CMR.

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Section: Discussionmentioning

confidence: 99%

“…Recently, two studies investigated AD measurement as a non-invasive tool to control the effect of renal denervation [4,11]. These studies included 58 and 28 patients, respectively.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Validation of simple measures of aortic distensibility based on standard 4-chamber cine CMR: a new approach for clinical studies

et al. 2019

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“…In the meantime, other potent predictors, such as elevated vascular stiffness could be used as surrogate markers for a biomechanical contribution to hypertension instead. [11,12,29–31]…”

Section: Lessons From Radiosound-htnmentioning

confidence: 99%

“…[2,3] In this group, biomechanical components such as vascular stiffening and increased wave reflections might outweigh the sympathomimetic contributors to an elevated BP. [11,12] Second, interference with antihypertensive medication, medication adherence and changes in treatment influence the effects of RDN on BP. Third, procedural factors, such as an unsuccessful or incomplete denervation procedure, could lead to a reduced or absent treatment effect.…”

mentioning

confidence: 99%

Lessons Learned from RADIOSOUND-HTN: Different Technologies and Techniques for Catheter-based Renal Denervation and Their Effect on Blood Pressure

Lurz

Fengler

2019

Interv Cardiol

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The interest in renal denervation (RDN) as a treatment for arterial hypertension has returned with three proof of principle trials that have shown recently RDN to be superior to sham treatment. Nevertheless, many questions about this treatment remain open, including those around the optimal interventional technique and technology. To clarify this important question, the authors designed and conducted the Randomized Trial of Different Renal Denervation Devices and Techniques in Patients with Resistant Hypertension (RADIOSOUND-HTN) trial, which compared three RDN treatment arms in a prospective randomised clinical trial. In this article, they comment on the background and results of this trial, and discuss which conclusions can be drawn from the trial, and which questions remain open for future studies in this field.

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Differential effects of inhibition of interleukin 1 and 6 on myocardial, coronary and vascular function

et al. 2019

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Cardiac magnetic resonance assessment of central and peripheral vascular function in patients undergoing renal sympathetic denervation as predictor for blood pressure response

Abstract: Beyond IPWV, AAD, cTAC and TAC appear as useful outcome predictors for RDN in patients with hypertension. CMR-derived markers of arterial stiffness might serve as non-invasive selection criteria for RDN.

Cited by 15 publications

References 134 publications

Validation of simple measures of aortic distensibility based on standard 4-chamber cine CMR: a new approach for clinical studies

Validation of simple measures of aortic distensibility based on standard 4-chamber cine CMR: a new approach for clinical studies

Lessons Learned from RADIOSOUND-HTN: Different Technologies and Techniques for Catheter-based Renal Denervation and Their Effect on Blood Pressure

Differential effects of inhibition of interleukin 1 and 6 on myocardial, coronary and vascular function

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