Plasma endothelin-1 levels in patients with resistant hypertension : effects of renal sympathetic denervation
INTRODUCTION: Resistant arterial hypertension (RHT) is defined as poor controlled blood pressure (BP) despite optimal doses of three or more antihypertensive agents, including a diuretic. In the development of RHT, hyperactivity of sympathetic (SNS) and renin-angiotensin-aldosterone (SRAA) systems are involved, and SNS is a potent stimulator of vasoactive endothelin-1 (ET-1) peptide. Renal sympathetic denervation (RSD) through disrupting renal afferent and efferent nerves attenuates SNS activity.
MATERIAL AND METHODS: We carried out pilot study investigating the effect of RSD on BP and plasma ET-1 levels in consecutive 9 RHT patients (7 male and 2 female, mean age of 56 ± 13.3).
RESULTS: After 12 months of the RSD, we observed a significant reduction of BP office, 24-h ambulatory BP monitoring (ABPM) (p < 0.05, respectively), and "non-dipping" pattern (from 55% to 35%) (p < 0.05). Moreover, RSD significantly decreased plasma ET-1 levels in both renal artery (at right from 21.8 ± 4.1 to 16.8 ± 2.9 pg/ml; p = 0.004; at left from 22.1 ± 3.7 to 18.9 ± 3.3 pg/ml; p = 0.02). We observed positive correlations between plasma renal arteries ET-1 levels and systolic BP values at ABPM [Global-SBP (r = 0.58; p < 0.01), Diurnal-SBP (r = 0.51; p < 0.03) and Nocturnal-SBP (r = 0.58; p < 0.01), respectively].
DISCUSSION: Our data confirmed the positive effects of RSD on BP values in patients with RHT, and showed a possible physio-pathological role of ET-1. KEY MESSAGES RSD is associated to a significant reduction of plasma ET-1 levels, representing an useful tool into reduction of BP in RHT patients.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2017 |
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| Erschienen: |
2017 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:49 |
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| Enthalten in: |
Annals of medicine - 49(2017), 5 vom: 21. Aug., Seite 396-403 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Petramala, Luigi [VerfasserIn] |
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| Links: |
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| Themen: |
Ambulatory blood pressure monitoring |
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| Anmerkungen: |
Date Completed 01.03.2018 Date Revised 15.05.2018 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1080/07853890.2017.1282623 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM267967098 |
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| 100 | 1 | |a Petramala, Luigi |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Plasma endothelin-1 levels in patients with resistant hypertension |b effects of renal sympathetic denervation |
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| 500 | |a Citation Status MEDLINE | ||
| 520 | |a INTRODUCTION: Resistant arterial hypertension (RHT) is defined as poor controlled blood pressure (BP) despite optimal doses of three or more antihypertensive agents, including a diuretic. In the development of RHT, hyperactivity of sympathetic (SNS) and renin-angiotensin-aldosterone (SRAA) systems are involved, and SNS is a potent stimulator of vasoactive endothelin-1 (ET-1) peptide. Renal sympathetic denervation (RSD) through disrupting renal afferent and efferent nerves attenuates SNS activity | ||
| 520 | |a MATERIAL AND METHODS: We carried out pilot study investigating the effect of RSD on BP and plasma ET-1 levels in consecutive 9 RHT patients (7 male and 2 female, mean age of 56 ± 13.3) | ||
| 520 | |a RESULTS: After 12 months of the RSD, we observed a significant reduction of BP office, 24-h ambulatory BP monitoring (ABPM) (p < 0.05, respectively), and "non-dipping" pattern (from 55% to 35%) (p < 0.05). Moreover, RSD significantly decreased plasma ET-1 levels in both renal artery (at right from 21.8 ± 4.1 to 16.8 ± 2.9 pg/ml; p = 0.004; at left from 22.1 ± 3.7 to 18.9 ± 3.3 pg/ml; p = 0.02). We observed positive correlations between plasma renal arteries ET-1 levels and systolic BP values at ABPM [Global-SBP (r = 0.58; p < 0.01), Diurnal-SBP (r = 0.51; p < 0.03) and Nocturnal-SBP (r = 0.58; p < 0.01), respectively] | ||
| 520 | |a DISCUSSION: Our data confirmed the positive effects of RSD on BP values in patients with RHT, and showed a possible physio-pathological role of ET-1. KEY MESSAGES RSD is associated to a significant reduction of plasma ET-1 levels, representing an useful tool into reduction of BP in RHT patients | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Ambulatory blood pressure monitoring | |
| 650 | 4 | |a endothelin-1 | |
| 650 | 4 | |a office blood pressure | |
| 650 | 4 | |a renal sympathetic denervation | |
| 650 | 4 | |a resistant arterial hypertension | |
| 650 | 7 | |a Endothelin-1 |2 NLM | |
| 700 | 1 | |a Olmati, Federica |e verfasserin |4 aut | |
| 700 | 1 | |a Mancone, Massimo |e verfasserin |4 aut | |
| 700 | 1 | |a Concistré, Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Galassi, Matteo |e verfasserin |4 aut | |
| 700 | 1 | |a Marinelli, Cristiano |e verfasserin |4 aut | |
| 700 | 1 | |a Tonnarini, Gianfranco |e verfasserin |4 aut | |
| 700 | 1 | |a Lucia, Piernatale |e verfasserin |4 aut | |
| 700 | 1 | |a Costi, Umberto |e verfasserin |4 aut | |
| 700 | 1 | |a Iannucci, Gino |e verfasserin |4 aut | |
| 700 | 1 | |a Sardella, Gennaro |e verfasserin |4 aut | |
| 700 | 1 | |a Letizia, Claudio |e verfasserin |4 aut | |
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