AIMS: To prove the efficacy and safety of renal sympathetic denervation as a new treatment option for patients suffering from resistant hypertension in a real-world setting. METHODS AND RESULTS: This single-centre real-world registry included 93 patients who underwent renal denervation employing the Symplicity system. Patients were followed for six months. The patient cohort was divided into early responders with a reduction of office systolic blood pressure >10 mmHg three months after the procedure (n=53, 57%), late responders (six months after the procedure, n=16, 17%) and non-responders (n=24, 26%). After six months, systolic blood pressure was lowered by 46±2.9 mmHg (mean±SEM, p<0.001), 31±3.4 mmHg (p<0.001) and 7.1±3.3 mmHg (p=0.79, ns), respectively. Ambulatory blood pressure monitoring also showed a significant reduction in the early responder group (20±5.7 mmHg, p=0.002). We subjected eight patients to a re-do procedure which led to a significant reduction of blood pressure in another five patients after six months (63%). One patient in this cohort developed a one-sided renal artery stenosis associated with an increase in blood pressure. CONCLUSIONS: This real-world analysis of renal sympathetic denervation confirms the procedure to be safe and efficient in the majority of patients. Non-responders may profit from a second ablation, arguing in favour of the hypothesis that the procedure did not destroy sufficient amounts of sympathetic innervation in these patients. However, repeated denervations may also increase side effects.
AIMS: To prove the efficacy and safety of renal sympathetic denervation as a new treatment option for patients suffering from resistant hypertension in a real-world setting. METHODS AND RESULTS: This single-centre real-world registry included 93 patients who underwent renal denervation employing the Symplicity system. Patients were followed for six months. The patient cohort was divided into early responders with a reduction of office systolic blood pressure >10 mmHg three months after the procedure (n=53, 57%), late responders (six months after the procedure, n=16, 17%) and non-responders (n=24, 26%). After six months, systolic blood pressure was lowered by 46±2.9 mmHg (mean±SEM, p<0.001), 31±3.4 mmHg (p<0.001) and 7.1±3.3 mmHg (p=0.79, ns), respectively. Ambulatory blood pressure monitoring also showed a significant reduction in the early responder group (20±5.7 mmHg, p=0.002). We subjected eight patients to a re-do procedure which led to a significant reduction of blood pressure in another five patients after six months (63%). One patient in this cohort developed a one-sided renal artery stenosis associated with an increase in blood pressure. CONCLUSIONS: This real-world analysis of renal sympathetic denervation confirms the procedure to be safe and efficient in the majority of patients. Non-responders may profit from a second ablation, arguing in favour of the hypothesis that the procedure did not destroy sufficient amounts of sympathetic innervation in these patients. However, repeated denervations may also increase side effects.
Authors: Abraham R Tzafriri; Felix Mahfoud; John H Keating; Peter M Markham; Anna Spognardi; Gee Wong; Kristine Fuimaono; Michael Böhm; Elazer R Edelman Journal: J Am Coll Cardiol Date: 2014-09-16 Impact factor: 24.094
Authors: Amy E Burchell; Kenneth Chan; Laura E K Ratcliffe; Emma C Hart; Manish Saxena; David J Collier; Ajay K Jain; Anthony Mathur; Charles J Knight; Mark J Caulfield; Julian F R Paton; Angus K Nightingale; Melvin D Lobo; Andreas Baumbach Journal: J Clin Hypertens (Greenwich) Date: 2016-02-09 Impact factor: 3.738
Authors: C Tsioufis; A Ziakas; K Dimitriadis; P Davlouros; M Marketou; A Kasiakogias; C Thomopoulos; D Petroglou; D Tsiachris; M Doumas; E Skalidis; C Karvounis; D Alexopoulos; P Vardas; I Kallikazaros; C Stefanadis; V Papademetriou; D Tousoulis Journal: Clin Res Cardiol Date: 2016-12-12 Impact factor: 5.460
Authors: Hitesh C Patel; Carl Hayward; Vassilis Vassiliou; Ketna Patel; James P Howard; Carlo Di Mario Journal: Integr Blood Press Control Date: 2015-12-03