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Review
. 2015 Mar 23;4(3):e001415.
doi: 10.1161/JAHA.114.001415.

Beyond blood pressure: percutaneous renal denervation for the management of sympathetic hyperactivity and associated disease states

Michael J McArdle  1 , Emil M deGoma  2 , Debbie L Cohen  3 , Raymond R Townsend  3 , Robert L Wilensky  2 , Jay Giri  2
Affiliations
Review

Beyond blood pressure: percutaneous renal denervation for the management of sympathetic hyperactivity and associated disease states

Michael J McArdle et al. J Am Heart Assoc. .
No abstract available

Keywords: atrial fibrillation; clinical trials; heart failure; metabolic syndrome; renal denervation; ventricular tachycardia.

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Figures

Figure 1
Figure 1
Sympathetic nervous system efferent activity stimulates the heart and arterial vasculature, causing pathological maladaptation. Afferent renal signals, induced by multiple inflammatory mediators, reflexively activate sympathetic outflow. RDN interrupts this pathological cycle. CNS indicates central nervous system; RDN, renal artery denervation.
Figure 2
Figure 2
Effect of renal artery denervation (RDN) on diastolic function. A, Mitral valve lateral E/E′ at baseline, 1 month, and 6 months in RDN and control patients. Although no significant changes could be detected in the control group, E/E′ significantly decreased in the RDN group. In the treatment group, P for trend was <0.001. B, Differential effect of RDN on E/E′ reduction depended on the degree of diastolic dysfunction at baseline. Reduction of E/E′ by RDN was significantly greater in those patients with an E/E′ above the median of 8.8 at baseline. Values are presented as mean±SE. Reproduced with permission from Brandt et al.25. RD indicates renal denervation.
Figure 3
Figure 3
Incidence of atrial fibrillation (AF) recurrences in all patients with and without renal artery denervation. AT indicates atrial tachycardia; PVI, pulmonary vein isolation. Reproduced with permission from Pokushalov et al.34
Figure 4
Figure 4
Change (SEM) in fasting glucose (A), fasting insulin (B), C‐peptide (C), and homeostasis model assessment—insulin resistance (HOMA‐IR) (D) at 1 month and 3 months compared with baseline. P values refer to change compared with baseline. Between‐group effects, measured by 2‐way repeated measures ANOVA, are given as P for interaction. Reproduced with permission from Mahfoud et al.45
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