Original title: Impaired Cardiac Baroreflex Sensitivity Predicts Response to Renal Sympathetic Denervation in Patients with Resistant Hypertension. Reference: Christine S. Zuern et al. J Am Coll Cardiol, article in press. Renal denervation is a new treatment option for patients with resistant arterial hypertension and it is assumed to reduce efferent renal and central sympathetic activity. Given the multifactorial...
Original title: Renal denervation in moderate treatment resistant hypertension. Reference: Christian Ott et al. J Am Coll Cardiol 2013. Article in press. Symplicity trials HTN1 and HTN 2 demonstrated that renal denervation is apparently safe in patients with severe resistant hypertension, (≥ 160 mm Hg despite ≥ 3 drugs including a diuretic). This cut of more than 160...
Original title: Effectiveness of Renal Denervation Therapy for Resistant Hypertension: A Systematic Review and Meta-Analysis. Reference: Mark I. Davis et al. J Am Coll Cardiol 2013. Article in press. Resistant Hypertension is the impossibility to control blood pressure despite the use of 3 or more different types of drugs, including diuretics. For most studies, at least 10 to...
Original title: Renal Sympathetic Denervation for Treatment of Drug-Resistant Hypertension Clinical Perspective Reference: Murray D. Ester et al. Circulation 2012; 126: 2976-2982 Renal sympathetic activation contributes to the pathogenesis of hypertension. The Symplicity HTN – 2 was a multicenter, randomized study which demonstrated that renal denervation produced a significant decrease in blood pressure at 6 months in patients...
Our editors talked with Dr. Marco Wainstein, an active member of SOLACI Web Editorial Board SOLACI WEB: Which is the rationale for renal denervation? Marco Wainstein, MD: The rationale for renal denervation is based on the modification of the sympathetic innervation of the renal arteries affecting both afferent and efferent nerves. Ultimately, renal denervation would...
Mild refractory hypertension patients were defined as those with daytime systolic BP 135-149 and diastolic BP 90-94 mmHg in ambulatory monitoring. They were randomized to renal denervation (n = 35) versus control invasive procedure (n = 36). The primary end point was the change in systolic pressure of 24 hours ambulatory monitoring at 6 months....
Pulmonary vessels are densely innervated by sympathetic, parasympathetic, and sensitive fibers. According to the World Health Organization (WHO) pulmonary arterial hypertension (PAH) grade 1 consists of obliterating pulmonary vascular remodeling accompanied by a diminished generation of vessel dilators. Its pharmacological treatment has certain limitations and sympathetic pulmonary vascular denervation might be a valid treatment alternative,...
Pulmonary artery denervation is associated with significant hemodynamics improvement, as well as improved clinical outcomes in patients with both post and precapillary pulmonary hypertension. Even though there are several studies on this technique, they included few patients (with different criteria and different devices), which is why we need more randomized studies. This prospective, randomized, study...
The clinical efficacy of renal endothelial sympathetic denervation using both radiofrequency and ultrasound endoscopy in the treatment of hypertension has already been proven. This is the first work comparing different techniques and technologies used to this end, which warranted its publication in Circulation. Patients with resistant hypertension were randomized 1:1:1 to: 1) radiofrequency denervation of...
Courtesy of Dr. Carlos Fava. The incidence of kidney disease is increasing. In its final stage, this pathology is related with coronary disease and increased mortality. Furthermore, we know that, in many occasions, it is associated with diabetes. Nowadays, the evidence comparing the progress of patients with impaired kidney function who have undergone left main...