Effects of renal sympathetic denervation on cardiac sympathetic activity and function in patients with therapy resistant hypertension.

Renal sympathetic denervation (RSD) is currently being investigated in multiple studies of sympathetically driven cardiovascular diseases such as heart failure and arrhythmias. Our aim was to assess systemic and cardiac sympatholytic effects of RSD by the measurement of cardiac sympathetic activity and cardiovascular parameters. A total of 21 consecutive patients with refractory hypertension (daytime ambulatory blood pressure (BP)≥150/100 mmHg despite the use of 3 or more antihypertensive drugs), no evidence for secondary hypertension and normal renovascular anatomy were included. RSD was performed with the Medtronic Symplicity renal denervation catheter with an average of 4.2 (range 3-6) ablations per renal artery. To assess cardiac sympathetic activity, 123I-mIBG cardiac scintigraphy was performed before and 6 weeks after. In addition, the effect of RSD on peripheral BP and cardiac hemodynamics were assessed non-invasively. 123I-mIBG uptake before and after RSD was 1.7±0.4% vs. 1.7±0.5% at 15 min. and 1.4±0.4% vs. 1.5±0.5% after 4 h. As a consequence, washout rate was similar before (33.7±11.7%) and after RSD (30.1±12.6%, p=0.27). In line with earlier RSD studies, a significant drop in systolic office BP (-12.2 mmHg, p=0.04) was detected, whereas the decrease in ambulatory BP was not significant. No changes were seen in heart rate, stroke volume or left ventricular contractility, both in supine position and after standing. In concert with previous reports, RSD leads to a significant drop in office BP. However, a reduction in sympathetic activity could not be demonstrated on a cardiac level.

van Brussel PM ，Eeftinck Schattenkerk DW ，Dobrowolski LC ，de Winter RJ ，Reekers JA ，Verberne HJ ，Vogt L ，van den Born BJ ... -  《-》

Effects of catheter-based renal denervation on cardiac sympathetic activity and innervation in patients with resistant hypertension.

Donazzan L ，Mahfoud F ，Ewen S ，Ukena C ，Cremers B ，Kirsch CM ，Hellwig D ，Eweiwi T ，Ezziddin S ，Esler M ，Böhm M ... -  《-》

Impact of renal sympathetic denervation on cardiac sympathetic nerve activity evaluated by cardiac MIBG imaging.

Berukstis A ，Vajauskas D ，Gargalskaite U ，Misonis N ，Burneikaite G ，Zakarkaite D ，Miglinas M ，Laucevicius A ... -  《-》

Renal denervation improves exercise blood pressure: insights from a randomized, sham-controlled trial.

Fengler K ，Heinemann D ，Okon T ，Röhnert K ，Stiermaier T ，von Röder M ，Besler C ，Müller U ，Höllriegel R ，Schuler G ，Desch S ，Lurz P ... -  《-》

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

Rebrova TY ，Ripp TM ，Afanasiev SA ，Mordovin VF ，Muslimova EF ... -  《TERAPEVTICHESKII ARKHIV》