Blood Pressure and Renal Responses to Orthostatic Stress Before and After Radiofrequency Renal Denervation in Patients with Resistant Hypertension.

Détails

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Etat: Public
Version: Final published version
Licence: CC BY 4.0
ID Serval
serval:BIB_9B71C90D5E6F
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Blood Pressure and Renal Responses to Orthostatic Stress Before and After Radiofrequency Renal Denervation in Patients with Resistant Hypertension.
Périodique
Frontiers in cardiovascular medicine
Auteur(s)
Vuignier Y., Grouzmann E., Muller O., Vakilzadeh N., Faouzi M., Maillard M.P., Qanadli S.D., Burnier M., Wuerzner G.
ISSN
2297-055X (Print)
ISSN-L
2297-055X
Statut éditorial
Publié
Date de publication
2018
Peer-reviewed
Oui
Volume
5
Pages
42
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: epublish
Résumé
In patients with resistant hypertension, renal denervation (RDN) studies have mainly focused their outcomes on blood pressure (BP). The aim of this study was to evaluate the long-term effect of RDN on neurohormonal profiles, renal hemodynamics and sodium excretion in a resting state and during stress induced by lower body negative pressure (LBNP).
This was a single center prospective observational study. Norepinephrine, plasma renin activity (PRA), glomerular filtration rate (GFR), renal plasma flow (RPF) and sodium excretion were measured in unstimulated conditions (rest) and after one hour of LBNP at three different time points: before (M0), one (M1) and twelve months (M12) after RDN.
Thirteen patients with resistant hypertension were included. In the resting state, no differences were observed in norepinephrine, PRA, sodium excretion and mean BP levels after RDN. GFR (78 ± 32 ml/min at M0 vs 66 ± 26 ml/min at M12 ( <i>p</i> = 0.012) and filtration fraction (22.6 ±5.4% at M0 vs 15.1 ±5.3% at M12 ( <i>p</i> = 0.002)) both decreased after RDN. During LBNP, the magnitude of the mean BP increase was reduced from +6.8 ± 6.6 mm Hg at M0 to +2.3 ± 1.3 mm Hg at M12 ( <i>p</i> = 0.005). The LBNP-induced increase in norepinephrine and decrease in GFR and sodium excretion observed before RDN were blunted after the procedure.
A decrease in GFR and filtration fraction was observed one year after RDN. In addition, our results suggest that RDN blunts not only the norepinephrine but also the mean BP, the GFR and the sodium excretion responses to an orthostatic stress one year after the intervention.
NCT01734096.
Mots-clé
glomerular filtration rate, hypertension, lower body negative pressure, renal denervation, renal plasma flow, sodium excretion, sympathetic nervous system
Pubmed
Open Access
Oui
Création de la notice
25/06/2018 17:12
Dernière modification de la notice
20/08/2019 16:02
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