Dataset Information

Predicting Renal Denervation Response in Resistant High Blood Pressure by Arterial Stiffness Assessment: A Systematic Review.

ABSTRACT:

Background

Accurately selecting hypertensive candidates for renal denervation (RDN) therapy is required, as one-third of patients who undergo RDN are non-responders. We aimed to systematically review the literature on RDN response prediction using arterial stiffness assessment, optimizing the selection of patients referred for interventional blood pressure lowering procedures.

Methods

A literature search was performed in MEDLINE, Embase, Scopus, and Cochrane databases to retrieve potential eligible studies from the inception to 30 June 2022.

Results

Ten studies were finally included in this systematic review. Studies consistently documented that invasive pulse wave velocity (PWV) was correlated with RDN's significant success. Nevertheless, non-invasive ambulatory arterial stiffness index and PWV derived from ambulatory blood pressure monitoring were independent predictors of blood pressure response (p = 0.04 and p < 0.0001). In some studies, magnetic resonance imaging parameters of arterial stiffness (ascending aortic distensibility, total arterial compliance) were correlated with blood pressure reduction (AUC = 0.828, p = 0.006).

Conclusions

Assessing arterial stiffness prior to RDN predicted procedural success, since stiffness parameters were strongly correlated with a significant blood pressure response. Our endeavor should be tackled as a step forward in selecting appropriate hypertensive patients scheduled for RDN therapy. Non-invasive measurements could be an alternative to invasive parameters for response prediction.

SUBMITTER: Burlacu A

PROVIDER: S-EPMC9410368 | biostudies-literature | 2022 Aug

REPOSITORIES: biostudies-literature

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Publications

Predicting Renal Denervation Response in Resistant High Blood Pressure by Arterial Stiffness Assessment: A Systematic Review.

Burlacu Alexandru A Brinza Crischentian C Floria Mariana M Stefan Anca Elena AE Covic Andreea A Covic Adrian A

Journal of clinical medicine 20220818 16

Background: Accurately selecting hypertensive candidates for renal denervation (RDN) therapy is required, as one-third of patients who undergo RDN are non-responders. We aimed to systematically review the literature on RDN response prediction using arterial stiffness assessment, optimizing the selection of patients referred for interventional blood pressure lowering procedures. Methods: A literature search was performed in MEDLINE, Embase, Scopus, and Cochrane databases to retrieve potential eli ...[more]

PMID: 36013092

Similar Datasets

Project description:BackgroundCentral aortic blood pressures and arterial stiffness are better indicators of cardiovascular outcomes than brachial blood pressures. However, their response to renal denervation (RDN) in patients with stage 3 and stage 4 chronic kidney disease (CKD) has not yet been examined.ObjectiveTo evaluate the impact of RDN on central blood pressures, brachial (office and ambulatory) blood pressures, arterial stiffness, glomerular filtration rate (GFR), 24-hour urine protein, and selective cardiac parameters observed on echocardiograms.DesignSingle-center, single-arm with pre-RDN/post-RDN follow-up.SettingPatients are being recruited from the multidisciplinary CKD clinic.PatientsFifty consecutive patients with stage 3 or stage 4 CKD and resistant hypertension, with no radiological or laboratory evidence of secondary causes of hypertension.MeasurementsThe key measurements are central blood pressures, pulse wave velocity, ambulatory 24-hour blood pressure, office blood pressures on BP Tru, GFR, 24-hour urine protein and sodium, blood pressure medication, and doses.MethodsFor our primary outcome, we will compare changes in central blood pressures from baseline to 6 months post RDN using a paired t test or Mann-Whitney U test. Secondary outcomes will examine changes in central blood pressures from baseline to 3, 12, 18, and 24 months post RDN as well as changes in office pressures, GFR, 24-hour urine protein and sodium, and medications at all time points using mixed-model analyses of variance or Friedman test. Multiple regression may be used to control for potential covariates.LimitationsSingle-center study, with no sham arm.ConclusionsAortic blood pressure, rather than brachial blood pressure, optimally reflects the load placed on the left ventricle. Aortic blood pressure is also better associated with cardiovascular outcomes. If our study shows a preferential decrease in central blood pressures and improvements in cardiac parameters on echocardiograms post RDN, this may influence the way in which blood pressures are managed in clinics and offices.Trial registrationClinicalTrials.gov (NCT01832233).

Dataset Information

Predicting Renal Denervation Response in Resistant High Blood Pressure by Arterial Stiffness Assessment: A Systematic Review.

Background

Methods

Results

Conclusions

Publications

Predicting Renal Denervation Response in Resistant High Blood Pressure by Arterial Stiffness Assessment: A Systematic Review.

Similar Datasets

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