Predictors of Renal Denervation Efficacy in the Treatment of Resistant Hypertension

Ripp, T.; Mordovin, V.; Pekarskiy, S.; Ryabova, Tamara; Злобина, М. В.; Baev, A.; Anfinogenova, Yana; Попов, С. В.

doi:10.1007/s11906-015-0603-8

Cited by 7 publications

(5 citation statements)

References 21 publications

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“…One study showed that the types of antihypertensive drugs decreased by 1.1 ( p < .00001). 19 Eleven studies 12 , 13 , 14 , 15 , 16 , 17 , 18 , 20 , 21 , 22 , 23 reported blood pressure levels after RDN treatment. Both systolic blood pressure and diastolic blood pressure decreased after RDN treatment (systolic blood pressure: −22.27, 95% CI: −23.95, −20.59; p < .00001; diastolic blood pressure: −8.14, 95% CI: −9.20, −7.07; p < .00001).…”

Section: Resultsmentioning

confidence: 99%

“…Previous studies have demonstrated RDN as a promising strategy for patients with RH, and current guidelines and consensus recommend that RDN may be a safe and effective method in patients with RH 8–11 . Although RDN can reliably lower blood pressure, its influence on the cardiac structure and function is inconsistent in different studies due to relatively small sample size, high heterogeneity of enrolled patients, and differences in operating methods and experience among different centers 12–23 . Therefore, this meta‐analysis evaluated the effect of RDN on cardiac remodeling in patients with RH undergoing RDN therapy.…”

Section: Introductionmentioning

confidence: 99%

“… 8 , 9 , 10 , 11 Although RDN can reliably lower blood pressure, its influence on the cardiac structure and function is inconsistent in different studies due to relatively small sample size, high heterogeneity of enrolled patients, and differences in operating methods and experience among different centers. 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 Therefore, this meta‐analysis evaluated the effect of RDN on cardiac remodeling in patients with RH undergoing RDN therapy.…”

Section: Introductionmentioning

confidence: 99%

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Impact of renal denervation on cardiac remodeling in resistant hypertension: A meta‐analysis

Xie,

Li,

Luo

et al. 2024

Clinical Cardiology

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Twelve studies involving 433 patients were included. After RDN treatment, LVMI decreased by 13.08 g/m2 (95% confidence interval [CI]: −18.38, −7.78; p < .00001), PWTd decreased by 0.60 mm (95% CI: −0.87, −0.34; p < .00001), IVSTd decreased by 0.78 mm (95% CI: −1.06, −0.49; p < .00001), and LVEF increased by 1.80% (95% CI: 0.71, 2.90; p = .001). However, there were no statistically significant improvements in LVIDd (95% CI: −1.40, 0.24; p = .17) and diastolic function (E/A) (95% CI: −0.04, 0.14; p = .28). Drug treatment for resistant hypertension (RH) is challenging. Renal denervation (RDN) is one of the most promising treatments for RH. Although studies have shown RDN can control blood pressure, the impacts of RDN on cardiac remodeling and cardiac function are unclear. This meta‐analysis evaluated the effect of RDN on cardiac structure and function in patients with RH. PubMed, Embase, and Cochrane were used to conduct a systematic search. The main inclusion criteria were studies on patients with RH who received RDN and reported the changes in echocardiographic parameters before and after RDN. Echocardiographic parameters included left ventricular mass index (LVMI), end‐diastolic left ventricular internal dimension (LVIDd), left ventricular end‐diastolic posterior wall thickness (PWTd), end‐diastolic interventricular septum thickness (IVSTd), E/A, and left ventricular ejection fraction (LVEF). Data was analyzed using RevMan. Twelve studies involving 433 patients were included. After RDN treatment, LVMI decreased by 13.08g/m2 (95%confidence interval [CI]: −18.38, −7.78, p < .00001), PWTd decreased by 0.60mm (95% CI: −0.87, −0.34, p < 0.00001), IVSTd decreased by 0.78mm (95% CI: −1.06, −0.49, p < .00001), and LVEF increased by 1.80% (95% CI: 0.71, 2.90, p = .001). However, there were no statistically significant improvements in LVIDd (95% CI: −1.40, 0.24, p = .17) and diastolic function (E/A) (95% CI: −0.04, 0.14, p =.28). This meta‐analysis finds that RDN can improve left ventricular hypertrophy and ejection fraction in patients with RH but has no significant effect on LVIDd and diastolic function. However, more studies are warranted due to the lack of a strict control group, a limited sample size, and research heterogeneity.

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Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Impact of renal denervation on cardiac remodeling in resistant hypertension: A meta‐analysis

Xie,

Li,

Luo

et al. 2024

Clinical Cardiology

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“…Анализ дизайна этого исследования показал несколько возможных причин отрицательного результата. Так, возникают вопросы по критериям подбора и оценке не всех больных, вошедших в группы исследования, отмечены технические «огрехи» и несовершенство технических устройств для процедуры, не всегда прослеживается последовательность ведения больных после процедуры ВРСД [17,18]. Кроме того, не разработаны критерии, позволяющие прогнозировать клинический эффект после процедуры [19].…”

Section: артериальная гипертония §unclassified

Selection of Patients with Resistant Arterial Hypertension for the Catheter-Based Renal Sympathetic Denervation

et al. 2019

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Purpose: elaboration of algorithm for selection of patients with resistant arterial hypertension (AH) for Catheter-Based Renal Sympathetic Denervation (CBRSD). Materials and methods. We examined 284 patients with resistant AH. On stage 1 we excluded most frequent causes of secondary AH. In 247 patients (86.9 %) we established secondary character of AH, in 37 patients (13.1 %) AH was found to be essential. On stage 2 patients with essential AH were given 3–5 component hypotensive therapy. At the background of this therapy we conducted 24‑hour ambulatory blood pressure monitoring (ABPM). CBRSD procedure was considered indicated if according to ABPM average 24‑hour blood pressure (BP) was above 150 and 100 mm Hg, and 24‑hour elevated BP load exceeded 60 %. In 13 of 37 patients (35 %) BP level satisfied these conditions. For CBRSD we used high frequency generator. Ablation was performed using the Symplicity Catheter. Results were assessed in 1, 2, 9, 12, and 28 months. Results.Target BP level at the background of minimal doses of hypotensive drugs was achieved in 11 patients (85 %), what was confirmed by ABPM data. Levels of mean 24–4 hour systolic and diastolic BP significantly decreased from 173.9±14.9 to 143±21.3, р<0.05, and from 108.2±8.7 to 91.4±13.8 mm Hg., р<0.05, respectively. Index of elevated systolic BP time decreased from 78.2±14.6 to 49.8±29.6 %, р<0.05. Best effect was achieved in patients with AH duration before the procedure less than 7 years. None of the patients had episodes of cerebral vascular insufficiency or heart failure progression. Conclusion. While determining indications to bilateral CBRSD one should be governed by such criteria as exclusion of symptomatic AH and objective proofs of AH resistance (according to ABPM at the background of hypotensive therapy).

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“…Однако кроме оценки эффективности этих мето-дов остаются неясными разные аспекты лечения: предикторы успеха и критерии эффективности про-цедур, длительность эффекта, возможность повреж-дения эндотелия сосудов, риск развития нежелатель-ных эффектов [22][23][24][25][26][27][28][29].…”

Section: фармакотерапия рагunclassified

Problem of resistant arterial hypertension in the family doctor practice

Korzh¹

2015

Shidnoevr. z. vnutr. simejnoi med.

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Predictors of Renal Denervation Efficacy in the Treatment of Resistant Hypertension

Abstract: #NCT01499810 https://clinicaltrials.gov/ct2/show/NCT01499810.

Cited by 7 publications

References 21 publications

Impact of renal denervation on cardiac remodeling in resistant hypertension: A meta‐analysis

Impact of renal denervation on cardiac remodeling in resistant hypertension: A meta‐analysis

Selection of Patients with Resistant Arterial Hypertension for the Catheter-Based Renal Sympathetic Denervation

Problem of resistant arterial hypertension in the family doctor practice

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