Changes in Plasma Renin Activity After Renal Artery Sympathetic Denervation
نویسندگان
چکیده
The renin-angiotensin-aldosterone system plays a key role in blood pressure (BP) regulation and is the target of several antihypertensive medications. Renal denervation (RDN) thought to interrupt sympathetic-mediated neurohormonal pathway as part its mechanism action reduce BP. purpose this study was evaluate plasma renin activity (PRA) aldosterone before after RDN assess whether these baseline neuroendocrine markers predict response RDN. Analyses were conducted patients with confirmed absence medication. Aldosterone PRA levels compared at 3 months post-procedure for sham control groups. Patients SPYRAL HTN-OFF MED Pivotal trial separated into 2 groups, those ≥0.65 ng/ml/h (n = 110) versus <0.65 116). Follow-up treatment differences between groups adjusted values using multivariable linear regression models. Baseline similar (1.0 ± 1.1 vs. ng/ml/h; p 0.37). Change from significantly greater subjects (−0.2 1.0 0.019 0.1 0.9 0.14), 0.001 subjects, seen aldosterone: (−1.2 6.4 ng/dl; 0.04 0.4 5.4 0.40), 0.011. Treatment 24-h office systolic (SBP) ng/ml/h, despite Differences SBP changes according also observed earlier weeks post-RDN. Plasma reduced when well control. Higher associated reduction SBP. (SPYRAL PIVOTAL - Study; NCT02439749)
منابع مشابه
Severe Renal Artery Stenosis After Renal Sympathetic Denervation.
W e present the case of a 73-year-old woman scheduled for renal angiography for severe recurrent refractory arterial hypertension 2 months after sympathetic renal denervation with the EnligHTN multielectrode catheter system (St Jude Medical, Saint Paul, Minnesota). The angiogram confirmed right renal artery subocclusive stenosis at the site of previous radiofrequency application (Figure 1). Aft...
متن کاملRenal sympathetic nerve activity after catheter-based renal denervation
BACKGROUND Catheter-based renal sympathetic denervation (RDN) has been considered a potential treatment for therapy resistant hypertension (RHT). However, in a randomized placebo-controlled trial, RDN did not lead to a substantial blood pressure (BP) reduction. We hypothesized that variation in the reported RDN efficacy might be explained by incomplete nerve disruption as assessed by renal 123I...
متن کاملRenal hemodynamics and plasma renin activity after renal artery constriction in conscious dogs.
Renal hemodynamics and plasma renin activity were studied during acute and chronic renal artery constriction produced by an externally controlled snare in conscious dogs. Renal vascular resistance immediately decreased, then increased to a level above control after approximately 1 hour, and continued to increase until the second day after constriction. Total renal flow rate was unchanged in the...
متن کاملPlasma Renin Activity Predicts the Improvement in Resistant Hypertension after Percutaneous Transluminal Renal Artery Angioplasty
Objective Percutaneous transluminal renal artery angioplasty (PTRA) has been recommended for the treatment of renovascular resistant hypertension. However, large randomized trials have reported that PTRA did not improve the outcomes compared with optimal medical therapy in patients with renal artery stenosis (RAS). It is important to identify patients with renovascular hypertension who are like...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
ژورنال
عنوان ژورنال: Journal of the American College of Cardiology
سال: 2021
ISSN: ['1558-3597', '0735-1097']
DOI: https://doi.org/10.1016/j.jacc.2021.04.044