BACKGROUND: High pulsatile pressure and flow in the arteries causes microvascular damage, and hence increased cardio-, and cerebrovascular complications. With advanced stages of hypertensive disease, an exaggerated pulsatile retinal capillary flow (RCF) has been shown, but data about interventional effect are missing. METHODS: Fifty-one patients with true treatment-resistant hypertension (TRH) underwent renal denervation (RDN) using the Symplicity Flex(™) catheter and were followed for 12 months. RCF was assessed non-invasively using Scanning laser Doppler flowmetry (SLDF) before, 6 (6 M), and 12 (12 M) months after RDN. RCF was measured in systole and diastole and pulsed RCF (difference of RCF in systole minus diastole) was calculated. In addition, flicker light-induced vasodilation (representing vasodilatory capacity) was assessed. RESULTS: Systolic and diastolic office blood pressure (BP) as well as 24-h ABPM decreased significantly 6 M and 12 M after RDN, compared to baseline values (all p < 0.001). There was a significant reduction of pulsed RCF 6 M (231 ± 81 versus 208 ± 68 AU, p = 0.046) and 12 M (194 ± 72 AU, p = 0.001) after RDN, whereas the mean RCF was unchanged. Moreover, there was a significant increase of flicker light-induced vasodilation after RDN (p = 0.043). CONCLUSION: In hypertensive patients with TRH, we observed a decrease of pulsed RCF 6 M and 12 M after RDN and an increase of vasodilatory capacity, in parallel to decreases in BP and heart rate. The reduction of pulsed RCF after RDN implies a decrease of shear stress on the vascular wall by the pulsed blood flow. This and the increment of vasodilatory capacity suggest an improvement of retinal (and potentially cerebral) microcirculation.
BACKGROUND: High pulsatile pressure and flow in the arteries causes microvascular damage, and hence increased cardio-, and cerebrovascular complications. With advanced stages of hypertensive disease, an exaggerated pulsatile retinal capillary flow (RCF) has been shown, but data about interventional effect are missing. METHODS: Fifty-one patients with true treatment-resistant hypertension (TRH) underwent renal denervation (RDN) using the Symplicity Flex(™) catheter and were followed for 12 months. RCF was assessed non-invasively using Scanning laser Doppler flowmetry (SLDF) before, 6 (6 M), and 12 (12 M) months after RDN. RCF was measured in systole and diastole and pulsed RCF (difference of RCF in systole minus diastole) was calculated. In addition, flicker light-induced vasodilation (representing vasodilatory capacity) was assessed. RESULTS: Systolic and diastolic office blood pressure (BP) as well as 24-h ABPM decreased significantly 6 M and 12 M after RDN, compared to baseline values (all p < 0.001). There was a significant reduction of pulsed RCF 6 M (231 ± 81 versus 208 ± 68 AU, p = 0.046) and 12 M (194 ± 72 AU, p = 0.001) after RDN, whereas the mean RCF was unchanged. Moreover, there was a significant increase of flicker light-induced vasodilation after RDN (p = 0.043). CONCLUSION: In hypertensivepatients with TRH, we observed a decrease of pulsed RCF 6 M and 12 M after RDN and an increase of vasodilatory capacity, in parallel to decreases in BP and heart rate. The reduction of pulsed RCF after RDN implies a decrease of shear stress on the vascular wall by the pulsed blood flow. This and the increment of vasodilatory capacity suggest an improvement of retinal (and potentially cerebral) microcirculation.
Authors: Christian Ott; Felix Mahfoud; Axel Schmid; Tilmann Ditting; Paul A Sobotka; Roland Veelken; Aline Spies; Christian Ukena; Ulrich Laufs; Michael Uder; Michael Böhm; Roland E Schmieder Journal: J Am Coll Cardiol Date: 2013-07-10 Impact factor: 24.094
Authors: Joanna M Harazny; Ulrike Raff; Jürgen Welzenbach; Christian Ott; Martin Ritt; Marina Lehmann; Georg Michelson; Roland E Schmieder Journal: J Hypertens Date: 2011-04 Impact factor: 4.844
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Authors: Guido T Dorner; Gerhard Garhofer; Barbara Kiss; Elzbieta Polska; Kaija Polak; Charles E Riva; Leopold Schmetterer Journal: Am J Physiol Heart Circ Physiol Date: 2003-05-15 Impact factor: 4.733
Authors: Christian Ott; Markus P Schlaich; Joanna Harazny; Bernhard Mw Schmidt; Georg Michelson; Roland E Schmieder Journal: J Hypertens Date: 2008-03 Impact factor: 4.844
Authors: Susanne Jung; Julie Kolwelter; Agnes Bosch; Renata Cífková; Joanna M Harazny; Christian Ott; Stephan Achenbach; Roland E Schmieder Journal: ESC Heart Fail Date: 2021-03-30
Authors: Andrew S P Sharp; Justin E Davies; Melvin D Lobo; Clare L Bent; Patrick B Mark; Amy E Burchell; Simon D Thackray; Una Martin; William S McKane; Robert T Gerber; James R Wilkinson; Tarek F Antonios; Timothy W Doulton; Tiffany Patterson; Piers C Clifford; Alistair Lindsay; Graeme J Houston; Jonathan Freedman; Neelan Das; Anna M Belli; Mohamad Faris; Trevor J Cleveland; Angus K Nightingale; Awais Hameed; Kalaivani Mahadevan; Judith A Finegold; Adam N Mather; Terry Levy; Richard D'Souza; Peter Riley; Jonathan G Moss; Carlo Di Mario; Simon R Redwood; Andreas Baumbach; Mark J Caulfield; Indranil Dasgupta Journal: Clin Res Cardiol Date: 2016-01-22 Impact factor: 5.460