Plasma endothelin-1 levels in patients with resistant hypertension. effects of renal sympathetic denervation
| Autor: | Petramala, Luigi, Olmati, Federica, Mancone, Massimo, Concistré, Antonio, Galassi, Matteo, Marinelli, Cristiano, Tonnarini, Gianfranco, Lucia, Piernatale, Costi, Umberto, Iannucci, Gino, Sardella, Gennaro, Letizia, Claudio, Tonnarini, Gian Franco |
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| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
Male
medicine.medical_specialty Ambulatory blood pressure medicine.medical_treatment Resistant hypertension office blood pressure Blood Pressure Pilot Projects 030204 cardiovascular system & hematology Kidney ambulatory blood pressure monitoring endothelin-1 renal sympathetic denervation resistant arterial hypertension medicine (all) 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Humans In patient 030212 general & internal medicine Sympathectomy Aged business.industry General Medicine Blood Pressure Monitoring Ambulatory Middle Aged Endothelin 1 Endocrinology Blood pressure Treatment Outcome Renal sympathetic denervation Hypertension Cardiology aged blood pressure blood pressure monitoring ambulatory female humans hypertension kidney male middle aged pilot projects sympathectomy treatmento outcome Female Diuretic business |
| Popis: | 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.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).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].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. |
| Databáze: | OpenAIRE |
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