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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
See this image and copyright information in PMC

References

    1. Davis MI, Filion KB, Zhang D, Eisenberg MJ, Afilalo J, Schiffrin EL, Joyal D. Effectiveness of renal denervation therapy for resistant hypertension: a systematic review and meta‐analysis. J Am Coll Cardiol. 2013;62:231–241. - PubMed
    1. Kandzari DE, Bhatt DL, Sobotka PA, O'Neill WW, Esler M, Flack JM, Katzen BT, Leon MB, Massaro JM, Negoita M, Oparil S, Rocha‐Singh K, Straley C, Townsend RR, Bakris GL. Catheter‐based renal denervation for resistant hypertension: rationale and design of the SYMPLICITY HTN‐3 trial. Clin Cardiol. 2012;35:528–535. - PMC - PubMed
    1. Bhatt DL, Kandzari DE, O'Neill WW, D'Agostino R, Flack JM, Katzen BT, Leon MB, Liu M, Mauri L, Negoita M, Cohen SA, Oparil S, Rocha‐Singh K, Townsend RR, Bakris GL. A controlled trial of renal denervation for resistant hypertension. N Engl J Med. 2014;370:1393–1401. - PubMed
    1. SYMPLICITY registry data spur further debate on role of renal denervation [Internet]; 2014. Available at: http://www.medscape.com/viewarticle/822839. Accessed December 20, 2014.
    1. Schmeider R. Hypertension: how should data from SYMPLICITY HTN‐3 be interpreted? Nat Rev Cardiol. 2014;11:375–376. - PubMed

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