eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
Current issue Archive Manuscripts accepted About the journal Abstracting and indexing Subscription Contact Instructions for authors
SCImago Journal & Country Rank
4/2018
vol. 14
 
Share:
Share:
more
 
 
abstract:
Review paper

Renal denervation – can we press the “ON” button again?

Jacek Kądziela, Ewa Warchoł-Celińska, Aleksander Prejbisz, Andrzej Januszewicz, Adam Witkowski, Konstantinos Tsioufis

Adv Interv Cardiol 2018; 14, 4 (54): 321–327
Online publish date: 2018/12/11
View full text
Get citation
ENW
EndNote
BIB
JabRef, Mendeley
RIS
Papers, Reference Manager, RefWorks, Zotero
AMA
APA
Chicago
Harvard
MLA
Vancouver
 
Nearly ten years ago percutaneous renal denervation (RDN) was introduced in clinical trials as a possible method of interventional treatment of resistant hypertension. The promising results of the first clinical trials initiated the intensive development of this method. However, the role of percutaneous renal denervation in the treatment of patients with resistant hypertension has been questioned since the results of the Symplicity HTN-3 trial have been published. It also resulted in downgrading the indications for RDN in the European Society of Cardiology/European Society of Hypertension Guidelines 2018. The authors discuss potential shortcomings of that trial, describe new generation devices and present the results of recently published trials: SPYRAL HTN-OFF MED, SPYRAL HTN-ON MED, RADIANCE-HTN SOLO and RADIOSOUND-HTN. The results of studies in patients with obstructive sleep apnea are also summarized and discussed. The upcoming large trials (SPYRAL PIVOTAL, RADIANCE II) are outlined – the results of those trials are expected to be published in the next 2–3 years. Until then, according to the European guidelines, the use of device-based therapies is not recommended for the treatment of hypertension, unless in the context of clinical studies and randomized controlled trials.
keywords:

renal denervation, resistant hypertension, review

references:
Krum H, Schlaich M, Whitbourn R, et al. Catheter-based renal sympathetic denervation for resistant hypertension: a multicentre safety and proof-of-principle cohort study. Lancet 2009; 373: 1275-81.
Symplicity HTN-1 Investigators. Catheter-based renal sympathetic denervation for resistant hypertension: durability of blood pressure reduction out to 24 months. Hypertension 2011; 57: 911-7. Esler MD, Krum H, Sobotka PA, et al. Renal sympathetic denervation in patients with treatment-resistant hypertension (The Symplicity HTN-2 Trial): a randomised controlled trial. Lancet 2010; 376: 1903-9.
Bhatt DL, Kandzari DE, O’Neill WW, et al. A controlled trial of renal denervation for resistant hypertension. N Engl J Med 2014; 370: 1393-401.
Mahfoud F, Bakris G, Bhatt DL, et al. Reduced blood pressure-lowering effect of catheter-based renal denervation in patients with isolated systolic hypertension: data from SYMPLICITY HTN-3 and the Global SYMPLICITY Registry. Eur Heart J 2017; 38: 93-100.
Kandzari DE, Bhatt DL, Brar S, et al. Predictors of blood pressure response in the SYMPLICITY HTN-3 trial. Eur Heart J 2015; 36: 219-27.
Flack JM, Bhatt DL, Kandzari DE, et al. An analysis of the blood pressure and safety outcomes to renal denervation in African Americans and non-African Americans in the SYMPLICITY HTN-3 trial. J Am Soc Hypertens 2015; 9: 769-79.
Sakakura K, Roth A, Ladich E, et al. Controlled circumferential renal sympathetic denervation with preservation of the renal arterial wall using intraluminal ultrasound: a next-generation approach for treating sympathetic overactivity. EuroIntervention 2015; 10: 1230-8.
Pathak A, Coleman L, Roth A, et al. Renal sympathetic nerve denervation using intraluminal ultrasound within a cooling balloon preserves the arterial wall and reduces sympathetic nerve activity. EuroIntervention 2015; 11: 477-884.
Sakakura K, Ladich E, Cheng Q, et al. Anatomic assessment of sympathetic peri-arterial renal nerves in man. J Am Coll Cardiol 2014; 64: 635-43.
Mahfoud F, Bohm M, Azizi M, et al. Proceedings from the European clinical consensus conference for renal denervation: considerations on future clinical trial design. Eur Heart J 2015; 36: 2219-27.
andzari DE, Kario K, Mahfoud F, et al. The Spyral htn global clinical trial program: rationale and design for studies of renal denervation in the absence (Spyral HTN OFF-MED) and presence (Spyral HTN ON-MED) of antihypertensive medications. Am Heart J 2016; 171: 82-91.
Townsend RR, Mahfoud F, Kandzari DE, et al. Catheter-based renal denervation in patients with uncontrolled hypertension in the absence of antihypertensive medications (Spyral HTN OFF-MED): a randomised, sham-controlled, proof-of-concept trial. Lancet 2017; 390: 2160-70.
Kandzari DE, Bohm M, Mahfoud F, et al. Effect of renal denervation on blood pressure in the presence of antihypertensive drugs: 6-month efficacy and safety results from the Spyral HTN ON-MED proof-of-concept randomised trial. Lancet 2018; 391: 2346-55.
Azizi M, Schmieder RE, Mahfoud F, et al. Endovascular ultrasound renal denervation to treat hypertension (Radiance-HTN solo): a multicentre, international, single-blind, randomised, sham-controlled trial. Lancet 2018; 391: 2335-45.
Fengler K, Rommel KP, Blazek S, et al. A three-arm randomized trial of different renal denervation devices and techniques in patients with resistant hypertension (RADIOSOUND-HTN). Circulation 2018 Epub ahead of print, 10.1161/CIRCULATIONAHA.118.037654.
Schmieder RE, Redon J, Grassi G, et al. Esh position paper: renal denervation – an interventional therapy of resistant hypertension. J Hypertens 2012; 30: 837-41.
Witkowski A, Prejbisz A, Florczak E, et al. Effects of renal sympathetic denervation on blood pressure, sleep apnea course, and glycemic control in patients with resistant hypertension and sleep apnea. Hypertension 2011; 58: 559-65.
Warchol-Celinska E, Prejbisz A, Kadziela J, et al. Renal denervation in resistant hypertension and obstructive sleep apnea: randomized proof-of-concept phase ii trial. Hypertension 2018; 72: 381-90.
Kario K, Bhatt DL, Kandzari DE, et al. Impact of renal denervation on patients with obstructive sleep apnea and resistant hypertension- insights from the symplicity htn-3 trial. Circ J 2016; 80: 1404-12.
Linz D, Mancia G, Mahfoud F, et al. Renal artery denervation for treatment of patients with self-reported obstructive sleep apnea and resistant hypertension: results from the global symplicity registry. J Hypertens 2017; 35: 148-53.
Daniels F, De Freitas S, Smyth A, et al. Effects of renal sympathetic denervation on blood pressure, sleep apnoea severity and metabolic indices: a prospective cohort study. Sleep Med 2017; 30: 180-4.
Williams B, Mancia G, Spiering W, et al. 2018 Practice Guidelines for the management of arterial hypertension of the European Society of Cardiology: ESH/ESC Task Force for the Management of Arterial Hypertension. J Hypertens 2018; 36: 2284-309.
Mauri L, Kario K, Basile J, et al. A multinational clinical approach to assessing the effectiveness of catheter-based ultrasound renal denervation: the RADIANCE-HTN and REQUIRE clinical study designs. Am Heart J 2018; 195: 115-29.
https://www.clinicaltrials.gov/ct2/show/NCT03614260
https://www.clinicaltrials.gov/ct2/show/study/NCT02439749
Quick links
© 2019 Termedia Sp. z o.o. All rights reserved.
Developed by Bentus.
PayU - płatności internetowe