Effect of renal denervation on long-term outcomes in patients with resistant hypertension

Liang, Bo; Liang, Yi; Li, Rui; Gu, Ning

doi:10.1186/s12933-021-01309-3

Cited by 7 publications

(3 citation statements)

References 51 publications

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“…Так называемые "острые" эффекты РЧ РД зачастую важнее в экспериментальных исследованиях на животных [36], в клинических же исследованиях с участием людей редко сообщается динамика показателей АД раньше 2 мес. после процедуры [37]. Первый мировой опыт применения мультиэлектродных систем в исследовании EnligHTN I (n=46) в 2014г также завершился сообщением о годичной динамике клинического и мониторного АД [38].…”

Section: Discussionunclassified

Experience of using multielectrode catheter systems to perform radiofrequency renal sympathetic denervation in patients with resistant hypertension: immediate procedural effects

et al. 2022

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Aim. To investigate the baseline characteristics of patients with resistant hypertension (HTN) undergoing radiofrequency renal sympathetic denervation (RD) and to determine immediate procedural effects.Material and methods. During 2018-2019, two series of radiofrequency RD procedures were performed in patients with true resistant HTN using balloon-type (bipolar ablation) or spiral-type (unipolar ablation) multielectorde catheters. The basic demographic, clinical and laboratory characteristics of included patients were assessed. A comparative analysis of two groups was carried out depending on the type of catheter used. Dynamics of office systolic blood pressure (SBP) were assessed as ∆ between the two following timepoints: at screening and at hospital discharge. The safety of radiofrequency RD was assessed. Multiple linear regression was used to determine the factors associated with the ∆ of office SBP after radiofrequency RD.Results. A total of 48 patients taking 4 (4;6) antihypertensive drugs were sequentially included. Radiofrequency RD was performed with a balloon-type catheter in 27 patients (mean age, 56±12 years old; 12 males) and with a spiral-type catheter in 21 patients (50±14 years old; 8 males). Radiofrequency RD was significantly longer in the spiral catheter group than in balloon one (110 versus 60 minutes, p<0,001), as was the mean number of RF applications (24 versus 12, p=0,002). None of the patients had acute kidney injury after RD (creatinine ∆, -0,6 µmol/L; 95% CI [-3,97; 2,78]). A total of 4 patients had complications (3 femoral arterial pseudoaneurisms, one renal arterial dissection), all of which did not affect the average length of hospital stay (from 4 to 5 days). At discharge, there was a pronounced decrease in office SBP (adjusted for baseline characteristics) with the mean of -26 mm Hg (95% CI [-29; -23]). There were following main factors associated with the office SBP ∆: smoking status (positive), baseline office SBP (positive), and blood glucose (negative).Conclusion. Radiofrequency RD using multielectode catheters is characterized by favorable short-term hemodynamic effects. We have found novel potential predictors of these effects. Further research will focus on testing initial hypotheses in the long term.

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Section: Discussionunclassified

Experience of using multielectrode catheter systems to perform radiofrequency renal sympathetic denervation in patients with resistant hypertension: immediate procedural effects

et al. 2022

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“…There were similar observations in the case reports reviewed here, but the overall findings note a net reduction in blood pressure at one year follow up. In addition, the intention to evaluate the office systolic blood pressure readings is further supported by contemporary literature as a modality to objectively evaluate blood pressure reduction effects[ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Catheter-based renal sympathetic nerve denervation on hypertension management outcomes

Singh¹,

Varghese²,

Qureshi³

et al. 2022

WJR

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BACKGROUND Renal sympathetic denervation (RSD) provides a minimally invasive interventional treatment modality for patients with resistant hypertension. However, the post-operative outcomes remain a key area of investigation since its earliest clinical trials. AIM To evaluate patient outcomes after RSD intervention among peer-reviewed patient cases. METHODS A systematic review of literature on MEDLINE, Google Scholar, and the Cochrane Database of Systematic Reviews for RSD case studies to assess post-operative hypertension readings and medical management. RESULTS Among 51 RSD cases, the post-operative RSD patients report an apparent reduction with a mean number of 3.1 antihypertensive medications. The mean systolic arterial blood pressure 1 year following RSD was 136.0 mmHg (95%CI: 118.7-153.3). CONCLUSION The apparent improvements in office systolic blood pressure after 12 month post-operative RSD can support the therapeutic potential of this intervention for blood pressure reduction. Additional studies which utilized a uniform methodology for blood pressure measurement can further support the findings of this systematic review.

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“…Hence, the effect of RDN on long-term HTN control is unclear. Yet, a recent analysis of nine trials demonstrated a sustained reduction in blood pressure of up to 3 years in some of the trials [ 19 ]. The overall complication rate remains low at 1.5%, yet the true burden of long-term complications, such as renal artery stenosis, cannot be fully estimated due to the lack of systematic follow-up imaging of renal arteries in most of the trials [ 20 ].…”

Section: Renal Denervationmentioning

confidence: 99%

The Potential Role of Renal Denervation in the Management of Heart Failure

Kassab

Soni

Kassier

et al. 2022

JCM

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Sympathetic nervous system activation in patients with heart failure is one of the main pathophysiologic mechanisms associated with the worse outcomes. Pharmacotherapies targeting neurohormonal activation have been at the center of heart failure management. Despite the advancement of therapies and the available treatments, heart failure continues to have an overall poor prognosis. Renal denervation was originally developed to lower systemic blood pressure in patients with poorly controlled hypertension, by modulating sympathetic outflow. However, more recently, multiple studies have investigated the effect of renal denervation in heart failure patients with both preserved (HFpEF) and reduced ejection fractions (HFrEF). This paper provides an overview of the potential effect of renal denervation in altering the various pathophysiologic, sympathetically mediated pathways that contribute to heart failure, and reviews the literature that supports its future use in those patients.

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Effect of renal denervation on long-term outcomes in patients with resistant hypertension

Cited by 7 publications

References 51 publications

Experience of using multielectrode catheter systems to perform radiofrequency renal sympathetic denervation in patients with resistant hypertension: immediate procedural effects

Experience of using multielectrode catheter systems to perform radiofrequency renal sympathetic denervation in patients with resistant hypertension: immediate procedural effects

Catheter-based renal sympathetic nerve denervation on hypertension management outcomes

The Potential Role of Renal Denervation in the Management of Heart Failure

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