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Renal sympathetic denervation restores aortic distensibility in patients with resistant hypertension: data from a multi-center trial

Renal sympathetic denervation (RDN) is under investigation as a treatment option in patients with resistant hypertension (RH). Determinants of arterial compliance may, however, help to predict the BP response to therapy. Aortic distensibility (AD) is a well-established parameter of aortic stiffness...

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Autores principales: Stoiber, Lukas, Mahfoud, Felix, Zamani, Seyedeh Mahsa, Lapinskas, Tomas, Böhm, Michael, Ewen, Sebastian, Kulenthiran, Saarraaken, Schlaich, Markus P., Esler, Murray D., Hammer, Tommy, Stensæth, Knut Haakon, Pieske, Burkert, Dreysse, Stephan, Fleck, Eckart, Kühne, Titus, Kelm, Marcus, Stawowy, Philipp, Kelle, Sebastian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6060801/
https://www.ncbi.nlm.nih.gov/pubmed/29520698
http://dx.doi.org/10.1007/s00392-018-1229-z
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author Stoiber, Lukas
Mahfoud, Felix
Zamani, Seyedeh Mahsa
Lapinskas, Tomas
Böhm, Michael
Ewen, Sebastian
Kulenthiran, Saarraaken
Schlaich, Markus P.
Esler, Murray D.
Hammer, Tommy
Stensæth, Knut Haakon
Pieske, Burkert
Dreysse, Stephan
Fleck, Eckart
Kühne, Titus
Kelm, Marcus
Stawowy, Philipp
Kelle, Sebastian
author_facet Stoiber, Lukas
Mahfoud, Felix
Zamani, Seyedeh Mahsa
Lapinskas, Tomas
Böhm, Michael
Ewen, Sebastian
Kulenthiran, Saarraaken
Schlaich, Markus P.
Esler, Murray D.
Hammer, Tommy
Stensæth, Knut Haakon
Pieske, Burkert
Dreysse, Stephan
Fleck, Eckart
Kühne, Titus
Kelm, Marcus
Stawowy, Philipp
Kelle, Sebastian
author_sort Stoiber, Lukas
collection PubMed
description Renal sympathetic denervation (RDN) is under investigation as a treatment option in patients with resistant hypertension (RH). Determinants of arterial compliance may, however, help to predict the BP response to therapy. Aortic distensibility (AD) is a well-established parameter of aortic stiffness and can reliably be obtained by CMR. This analysis sought to investigate the effects of RDN on AD and to assess the predictive value of pre-treatment AD for BP changes. We analyzed data of 65 patients with RH included in a multicenter trial. RDN was performed in all participants. A standardized CMR protocol was utilized at baseline and at 6-month follow-up. AD was determined as the change in cross-sectional aortic area per unit change in BP. Office BP decreased significantly from 173/92 ± 24/16 mmHg at baseline to 151/85 ± 24/17 mmHg (p < 0.001) 6 months after RDN. Maximum aortic areas increased from 604.7 ± 157.7 to 621.1 ± 157.3 mm(2) (p = 0.011). AD improved significantly by 33% from 1.52 ± 0.82 to 2.02 ± 0.93 × 10(−3) mmHg(−1) (p < 0.001). Increase of AD at follow-up was significantly more pronounced in younger patients (p = 0.005) and responders to RDN (p = 0.002). Patients with high-baseline AD were significantly younger (61.4 ± 10.1 vs. 67.1 ± 8.4 years, p = 0.022). However, there was no significant correlation of baseline AD to response to RDN. AD is improved after RDN across all age groups. Importantly, these improvements appear to be unrelated to observed BP changes, suggesting that RDN may have direct effects on the central vasculature. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00392-018-1229-z) contains supplementary material, which is available to authorized users.
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spelling pubmed-60608012018-08-09 Renal sympathetic denervation restores aortic distensibility in patients with resistant hypertension: data from a multi-center trial Stoiber, Lukas Mahfoud, Felix Zamani, Seyedeh Mahsa Lapinskas, Tomas Böhm, Michael Ewen, Sebastian Kulenthiran, Saarraaken Schlaich, Markus P. Esler, Murray D. Hammer, Tommy Stensæth, Knut Haakon Pieske, Burkert Dreysse, Stephan Fleck, Eckart Kühne, Titus Kelm, Marcus Stawowy, Philipp Kelle, Sebastian Clin Res Cardiol Original Paper Renal sympathetic denervation (RDN) is under investigation as a treatment option in patients with resistant hypertension (RH). Determinants of arterial compliance may, however, help to predict the BP response to therapy. Aortic distensibility (AD) is a well-established parameter of aortic stiffness and can reliably be obtained by CMR. This analysis sought to investigate the effects of RDN on AD and to assess the predictive value of pre-treatment AD for BP changes. We analyzed data of 65 patients with RH included in a multicenter trial. RDN was performed in all participants. A standardized CMR protocol was utilized at baseline and at 6-month follow-up. AD was determined as the change in cross-sectional aortic area per unit change in BP. Office BP decreased significantly from 173/92 ± 24/16 mmHg at baseline to 151/85 ± 24/17 mmHg (p < 0.001) 6 months after RDN. Maximum aortic areas increased from 604.7 ± 157.7 to 621.1 ± 157.3 mm(2) (p = 0.011). AD improved significantly by 33% from 1.52 ± 0.82 to 2.02 ± 0.93 × 10(−3) mmHg(−1) (p < 0.001). Increase of AD at follow-up was significantly more pronounced in younger patients (p = 0.005) and responders to RDN (p = 0.002). Patients with high-baseline AD were significantly younger (61.4 ± 10.1 vs. 67.1 ± 8.4 years, p = 0.022). However, there was no significant correlation of baseline AD to response to RDN. AD is improved after RDN across all age groups. Importantly, these improvements appear to be unrelated to observed BP changes, suggesting that RDN may have direct effects on the central vasculature. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s00392-018-1229-z) contains supplementary material, which is available to authorized users. Springer Berlin Heidelberg 2018-03-08 2018 /pmc/articles/PMC6060801/ /pubmed/29520698 http://dx.doi.org/10.1007/s00392-018-1229-z Text en © The Author(s) 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.
spellingShingle Original Paper
Stoiber, Lukas
Mahfoud, Felix
Zamani, Seyedeh Mahsa
Lapinskas, Tomas
Böhm, Michael
Ewen, Sebastian
Kulenthiran, Saarraaken
Schlaich, Markus P.
Esler, Murray D.
Hammer, Tommy
Stensæth, Knut Haakon
Pieske, Burkert
Dreysse, Stephan
Fleck, Eckart
Kühne, Titus
Kelm, Marcus
Stawowy, Philipp
Kelle, Sebastian
Renal sympathetic denervation restores aortic distensibility in patients with resistant hypertension: data from a multi-center trial
title Renal sympathetic denervation restores aortic distensibility in patients with resistant hypertension: data from a multi-center trial
title_full Renal sympathetic denervation restores aortic distensibility in patients with resistant hypertension: data from a multi-center trial
title_fullStr Renal sympathetic denervation restores aortic distensibility in patients with resistant hypertension: data from a multi-center trial
title_full_unstemmed Renal sympathetic denervation restores aortic distensibility in patients with resistant hypertension: data from a multi-center trial
title_short Renal sympathetic denervation restores aortic distensibility in patients with resistant hypertension: data from a multi-center trial
title_sort renal sympathetic denervation restores aortic distensibility in patients with resistant hypertension: data from a multi-center trial
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6060801/
https://www.ncbi.nlm.nih.gov/pubmed/29520698
http://dx.doi.org/10.1007/s00392-018-1229-z
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