Possibility of evaluating the effectiveness of renal artery sympathetic denervation in resistant hypertension early after radiofrequency ablation

Rebrova, Т. Yu.; Реброва, Т. Ю.; Ripp, T.; Afanasiev, S. A.; Афанасьев, С. А.; Mordovin, V.; Mordovin, V.; Муслимова, Э. Ф.

doi:10.17116/terarkh201688810-13

Cited by 5 publications

(2 citation statements)

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“…Для решения проблемы отбора больных предлагается выполнение исходного более детального их обследования для выявления симптоматических форм и псевдорезистентности [5,6]. В настоящее время разработан способ отбора пациентов для выполнения процедуры РД и получения выраженного антигипертензивного эффекта, учитывающий, помимо исходного уровня АД, уровень бета-адренореактивности мембран эритроцитов (бета-АРМ) [7]; кроме того, возможно прогнозирование краткосрочного эффекта процедуры по изменению уровня бета-АРМ через 7 дней после вмешательства [8].…”

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Erythrocyte membranes beta-adrenoreactivity changes after renal denervation in patients with resistant hypertension, relationship with antihypertensive and cardioprotective intervention efficacy

et al. 2021

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Aim To study the functional condition of sympathoadrenal system as evaluated by beta-adrenoreactivity of erythrocyte membranes (beta-ARM) during two years following renal denervation (RD) in patients with resistant arterial hypertension (RAH) and to determine the relationship of this index with long-term antihypertensive and cardioprotective effectivity of this invasive treatment.Material and methods The study included 48 patients (mean age, 57.2±8.7 years, 18 men) with RAH on a stable antihypertensive therapy. Averaged daily systolic and diastolic blood pressure (SBP and DBP) and levels of beta-ARM were determined at baseline and in 7 days and 2 years following RD. Measurement of beta-ARM was based on beta-adrenoblocker inhibition of erythrocyte hemolysis induced by exposure to hypo-osmotic environment. The beta-adrenoblocker binds to erythrocyte membrane beta-adrenoceptors to prevent the erythrocyte destruction. Increased values of beta-ARM reflect a decrease in the number of functionally active erythrocyte membrane beta-adrenoceptors associated with long-term sympathetic hyperactivity.Results For two years of follow-up, values of average daily BP decreased from 160.4±16.0 / 88.1±14.6 to 145.3±19.3 / 79.4±13.6 mm Hg. At 7 days, the number of beta-ARM had decreased in the group of RD responders (р=0.028) who at two years had decreased their BP by 10 mm Hg or more, while in the group of non-responders, the number of beta-ARM remained unchanged. At one week, beta-ARM values correlated with changes in SBP and DBP (r= –0.54; р<0.05) and with left ventricular myocardial mass (LVMM) (r= –0.36; р<0.05) at two years of follow-up whereas beta-ARM delta at one week was interrelated with the renin concentration in the long-term (r= –0.44; р<0.05). At two years, the content of beta-ARM was increased in both groups.Conclusion The decrease in beta-ARM content at 7 days after RD shows the procedure efficacy and allows an expectation of clinically significant decreases in BP and LVMM in the long-term after the surgical treatment. At two years after the intervention, the content of beta-ARM increased, and the BP decrease was apparently due to some other mechanisms.

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Section: автор для перепискиunclassified

Erythrocyte membranes beta-adrenoreactivity changes after renal denervation in patients with resistant hypertension, relationship with antihypertensive and cardioprotective intervention efficacy

et al. 2021

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“…При этом на процесс ингибирования осмолиза эритроцитов воздействует количество функционально активных бета-адренорецепторов на мембране клеток, что указывает на их адренореактивность. Данный метод лег в основу многочисленных исследований по изучению адренореактивности при различных патологических состояниях, в том числе сердечно-сосудистых заболеваниях [12][13][14][15][16]. Тем не менее, количество работ, посвященных изучению бета-адренореактивности (β-АРМ) у пациентов с ХСН, сравнительно невелико, а проспективные исследования по анализу данного показателя при ХСН у пациентов с перенесенным ИМ практически отсутствуют, что послужило основой для проведения настоящего исследования.…”

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Association of Adrenoreactivity With the Stage of Chronic Heart Failure in Patients With Previous Myocardial Infarction

Александренко

Rebrova

Afanasiev

et al. 2019

SMJ

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Objective. To identify associations of beta-adrenoreactivity with stage of chronic heart failure (CHF) in patient with previousmyocardial infarction (MI).Material and Methods. A total of 50 patients with CHF underwent an analysis of adrenoreactivity based on the changes in red blood cellosmoresistance in the presence of adrenergic blocker to determine the activity of the sympathoadrenal system a year after MI.Results. Higher levels of beta-adrenoreactivity (β-ARM) were characteristic of patients with CHF of higher gradations: 61.8(47.5;74.8) с.u. in patients with stage IIA CHF versus 48.7 (39;65.2) с.u. in patients with stage I CHF, p=0.037.Conclusion. These results may suggest the diagnostic value of the indicator of adrenoreactivity and its possible use as a newbiomarker for assessing the severity of CHF in patients with previous myocardial infarction.

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Five-year dynamics adrenergic reactivity of erythrocytes after radio-frequency sympathic denervation of renal arteries in patients with resistant arterial hypertension

Rebrova,

Falkovskaya,

Afanasiev

et al. 2023

Terapevticheskii arkhiv

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Aim. To study the initial state of adrenergic reactivity and the five-year dynamics of the beta-adrenergic reactivity index of erythrocyte membranes and the manifestation of the antihypertensive effect of the procedure for radiofrequency destruction of sympathetic structures of the renal artery in patients with resistant arterial hypertension. Subjects and methods. The analysis included 42 patients with resistant arterial hypertension (RH). The renal denervation (RD) procedure of the kidneys was performed by endovascular bilateral transcatheter radiofrequency ablation of the renal arteries. The study of 24-hour blood pressure monitoring (BPM) and the determination of -adrenoreactivity of erythrocytes (-ARM) by changes in the osmoresistance of erythrocyte membranes were performed initially, 1 week, 6 months, 1, 2, 3 and 5 years after RD. Patients retrospectively, at a follow-up period of 6 months after RD, were divided into responders (decrease in blood pressure by 10 or more mm Hg) and non-responders (decrease in blood pressure less than 10 mm Hg). Results. 6 months after the RD, the number of responders was 28 people (66.7%), after 5 years - 31 people (73.8%). At the time of inclusion in the study, the median -ARM in the group of non-responders was not significantly higher than in the group of responders. After 6 months after the RD procedure, the -ARM indicator in the non-responder group was significantly lower than in the responder group (p = 0.043). With further follow-up in the group of responders, an increase in the median -ARM was noted, which reached significant differences relative to the baseline values in the group at follow-up periods of 1 year (p = 0.036) and 5 years (p = 0.004) after RD. The change in the -ARM indicator in the non-responder group was wavy in nature, the changes did not reach the significance criteria. Conclusion. Renal denervation in 73.8% of cases is accompanied by a stable antihypertensive response for 5 years of observation and an increase in -ARM, which may indicate the implementation of compensatory mechanisms in conditions of increasing activity of the sympathoadrenal system in response to a decrease in blood pressure.

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Possibility of evaluating the effectiveness of renal artery sympathetic denervation in resistant hypertension early after radiofrequency ablation

Abstract: The decline in the β-AR of EM within the first week after RFA is suggestive of the decreased activity of the sympathoadrenal system and may be used as an early efficiency index of RSD after the procedure.

Cited by 5 publications

References 4 publications

Erythrocyte membranes beta-adrenoreactivity changes after renal denervation in patients with resistant hypertension, relationship with antihypertensive and cardioprotective intervention efficacy

Erythrocyte membranes beta-adrenoreactivity changes after renal denervation in patients with resistant hypertension, relationship with antihypertensive and cardioprotective intervention efficacy

Association of Adrenoreactivity With the Stage of Chronic Heart Failure in Patients With Previous Myocardial Infarction

Five-year dynamics adrenergic reactivity of erythrocytes after radio-frequency sympathic denervation of renal arteries in patients with resistant arterial hypertension

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