Beneficial effects of renal sympathetic denervation on cardiovascular inflammation and remodeling in essential hypertension.

Dörr, Oliver; Liebetrau, Christoph; Möllmann, Helge; Mahfoud, Felix; Ewen, Sebastian; Gaede, Luise; Troidl, Christian; Hoffmann, Jedrzej; Busch, Nikolai; Laux, Gerald; Wiebe, Jens; Bauer, Timm; Hamm, Christian; Nef, Holger

doi:10.1007/s00392-014-0773-4

2015

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Document type:: Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't
Author(s):: Dörr, Oliver; Liebetrau, Christoph; Möllmann, Helge; Mahfoud, Felix; Ewen, Sebastian; Gaede, Luise; Troidl, Christian; Hoffmann, Jedrzej; Busch, Nikolai; Laux, Gerald; Wiebe, Jens; Bauer, Timm; Hamm, Christian; Nef, Holger
Title:: Beneficial effects of renal sympathetic denervation on cardiovascular inflammation and remodeling in essential hypertension.
Abstract:: Renal sympathetic denervation (RSD) represents a potential treatment option for certain patients with resistant arterial hypertension (HT). HT is associated with chronic vascular inflammation and remodeling, contributing to progressive vascular damage, and atherosclerosis. The present study aimed to evaluate the influence of RSD on cardiovascular inflammation and remodeling by determining serum levels of interleukin-6 (IL-6), high-sensitive C-reactive protein (hsCRP), matrix metalloproteinases (MMP), and tissue inhibitor of metalloproteinases (TIMP).A total of 60 consecutive patients (age 67.9 ± 9.6 years) undergoing RSD were included. A therapeutic response was defined as an office systolic blood pressure (SBP) reduction of >10 mmHg 6 months after RSD. Venous serum samples for measurement of hsCRP, IL-6, MMP-2, MMP-9, and TIMP-1 were collected prior to and 6 months after RSD.A significant reduction in office SBP of 26.4 mmHg [SBPbaseline 169.3 mmHg (SD 11.3), p < 0.001] was documented 6 months after RSD. The serum levels of hsCRP (p < 0.001) and the pro-inflammatory cytokine IL-6 (p < 0.001) were significantly decreased compared to baseline values. The levels of MMP-9 (p = 0.024) and MMP-2 (p < 0.01) were significantly increased compared to baseline values.In addition to the effective blood pressure reduction in response to RSD, this study demonstrates a positive effect of RSD on biomarkers reflecting vascular inflammation and remodeling. These results suggest a possible prognostic benefit of RSD in high-risk patients for endothelial dysfunction and cardiovascular remodeling as well as end-organ damage.
Journal title abbreviation:: Clin Res Cardiol
Year:: 2015
Journal volume:: 104
Journal issue:: 2
Pages contribution:: 175-84
Language:: eng
Fulltext / DOI:: doi:10.1007/s00392-014-0773-4
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/25326158
Print-ISSN:: 1861-0684
TUM Institution:: Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (Prof. Schunkert)
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mediaTUM Gesamtbestand Einrichtungen Schools TUM School of Medicine and Health Departments Clinical Medicine Lehr- und Forschungskooperationen mit den Kliniken und Instituten am Deutschen Herzzentrum Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (DHM) (Prof. Schunkert)2015