Renal sympathetic denervation in therapy resistant hypertension-pathophysiological aspects and predictors for treatment success
Many forms of human hypertension are associated with an increased systemic sympathetic activity. Especially the renal sympathetic nervous system has been found to play a prominent role in this context. Therefore, catheterinterventional renal sympathetic denervation(RDN) has been established as a tre...
Gespeichert in:
Veröffentlicht in: | World journal of cardiology 2016-08, Vol.8 (8), p.436-446 |
---|---|
Hauptverfasser: | , , , , |
Format: | Artikel |
Sprache: | eng |
Schlagworte: | |
Online-Zugang: | Volltext |
Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
container_end_page | 446 |
---|---|
container_issue | 8 |
container_start_page | 436 |
container_title | World journal of cardiology |
container_volume | 8 |
creator | Fengler, Karl Rommel, Karl Philipp Okon, Thomas Schuler, Gerhard Lurz, Philipp |
description | Many forms of human hypertension are associated with an increased systemic sympathetic activity. Especially the renal sympathetic nervous system has been found to play a prominent role in this context. Therefore, catheterinterventional renal sympathetic denervation(RDN) has been established as a treatment for patients suffering from therapy resistant hypertension in the past decade. The initial enthusiasm for this treatment was markedly dampened by the results of the Symplicity-HTN-3 trial, although the transferability of the results into clinical practice to date appears to be questionable. In contrast to the extensive use of RDN in treating hypertensive patients within or without clinical trial settings over the past years, its effects on the complex pathophysiological mechanisms underlying therapy resistant hypertension are only partly understood and are part of ongoing research. Effects of RDN have been described on many levels in human trials: From altered systemic sympathetic activity across cardiac and metabolic alterations down to changes in renal function. Most of these changes could sustainably change long-term morbidity and mortality of the treated patients, even if blood pressure remains unchanged. Furthermore, a number of promising predictors for a successful treatment with RDN have been identified recently and further trials are ongoing. This will certainly help to improve the preselection of potential candidates for RDN and thereby optimize treatment outcomes. This review summarizes important pathophysiologic effects of renal denervation and illustrates the currently known predictors for therapy success. |
doi_str_mv | 10.4330/wjc.v8.i8.436 |
format | Article |
fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4997524</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><cqvip_id>87748890504849544856484849</cqvip_id><sourcerecordid>1819429595</sourcerecordid><originalsourceid>FETCH-LOGICAL-c361t-8eae5cd9b7874f0733980413277910f7ca28e61f4f0eb5c0aeef4db57be173c63</originalsourceid><addsrcrecordid>eNpVUU1r3DAUNKUlCUmOuRYde_FWX7akS6GEpg0ECiU9C1l-XivYkiNpt_iUv14t2S6pLprRG40GTVXdELzhjOHPf57sZi83ThbavqsuiOKqlryl79_g8-o6pSdcFucCU3pWnVPRUiIEuahefoE3E0rrvJg8QnYW9eAh7k12wSPnUTmNZllRhORSNj6jcV0gZvCpKOrDtbCMayFT2DpbzExawOaEjO_REqF3NoeY0BAiyhFMnqGYpJ21kNJV9WEwU4Lr435Z_b779nj7o374-f3-9utDbVlLci3BQGN71Qkp-IAFY0piThgVQhE8CGuohJYMZQZdY7EBGHjfNaIDIpht2WX15dV32XUz9LZEiGbSS3SziasOxun_J96Nehv2mislGsqLwaejQQzPO0hZzy5ZmCbjIeySJrJ8OFWNaoq0fpXaGFKKMJyeIVgfetOlN72X2slCD9k-vs12Uv9rqQjY0XAMfvvs_PakkUJwKRVuMJdcNZzLpi2oYPYXXDmpuw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1819429595</pqid></control><display><type>article</type><title>Renal sympathetic denervation in therapy resistant hypertension-pathophysiological aspects and predictors for treatment success</title><source>Baishideng "World Journal of" online journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><creator>Fengler, Karl ; Rommel, Karl Philipp ; Okon, Thomas ; Schuler, Gerhard ; Lurz, Philipp</creator><creatorcontrib>Fengler, Karl ; Rommel, Karl Philipp ; Okon, Thomas ; Schuler, Gerhard ; Lurz, Philipp</creatorcontrib><description>Many forms of human hypertension are associated with an increased systemic sympathetic activity. Especially the renal sympathetic nervous system has been found to play a prominent role in this context. Therefore, catheterinterventional renal sympathetic denervation(RDN) has been established as a treatment for patients suffering from therapy resistant hypertension in the past decade. The initial enthusiasm for this treatment was markedly dampened by the results of the Symplicity-HTN-3 trial, although the transferability of the results into clinical practice to date appears to be questionable. In contrast to the extensive use of RDN in treating hypertensive patients within or without clinical trial settings over the past years, its effects on the complex pathophysiological mechanisms underlying therapy resistant hypertension are only partly understood and are part of ongoing research. Effects of RDN have been described on many levels in human trials: From altered systemic sympathetic activity across cardiac and metabolic alterations down to changes in renal function. Most of these changes could sustainably change long-term morbidity and mortality of the treated patients, even if blood pressure remains unchanged. Furthermore, a number of promising predictors for a successful treatment with RDN have been identified recently and further trials are ongoing. This will certainly help to improve the preselection of potential candidates for RDN and thereby optimize treatment outcomes. This review summarizes important pathophysiologic effects of renal denervation and illustrates the currently known predictors for therapy success.</description><identifier>ISSN: 1949-8462</identifier><identifier>EISSN: 1949-8462</identifier><identifier>DOI: 10.4330/wjc.v8.i8.436</identifier><identifier>PMID: 27621771</identifier><language>eng</language><publisher>United States: Baishideng Publishing Group Inc</publisher><subject>denervation;Sympathetic ; hypertension ; nervous ; Renal ; Review ; sympathetic ; system;Predictors;Hypertension;Renal</subject><ispartof>World journal of cardiology, 2016-08, Vol.8 (8), p.436-446</ispartof><rights>The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved. 2016</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c361t-8eae5cd9b7874f0733980413277910f7ca28e61f4f0eb5c0aeef4db57be173c63</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Uhttp://image.cqvip.com/vip1000/qk/71417X/71417X.jpg</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4997524/pdf/$$EPDF$$P50$$Gpubmedcentral$$H</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4997524/$$EHTML$$P50$$Gpubmedcentral$$H</linktohtml><link.rule.ids>230,314,723,776,780,881,27903,27904,53769,53771</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27621771$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Fengler, Karl</creatorcontrib><creatorcontrib>Rommel, Karl Philipp</creatorcontrib><creatorcontrib>Okon, Thomas</creatorcontrib><creatorcontrib>Schuler, Gerhard</creatorcontrib><creatorcontrib>Lurz, Philipp</creatorcontrib><title>Renal sympathetic denervation in therapy resistant hypertension-pathophysiological aspects and predictors for treatment success</title><title>World journal of cardiology</title><addtitle>World Journal of Cardiology</addtitle><description>Many forms of human hypertension are associated with an increased systemic sympathetic activity. Especially the renal sympathetic nervous system has been found to play a prominent role in this context. Therefore, catheterinterventional renal sympathetic denervation(RDN) has been established as a treatment for patients suffering from therapy resistant hypertension in the past decade. The initial enthusiasm for this treatment was markedly dampened by the results of the Symplicity-HTN-3 trial, although the transferability of the results into clinical practice to date appears to be questionable. In contrast to the extensive use of RDN in treating hypertensive patients within or without clinical trial settings over the past years, its effects on the complex pathophysiological mechanisms underlying therapy resistant hypertension are only partly understood and are part of ongoing research. Effects of RDN have been described on many levels in human trials: From altered systemic sympathetic activity across cardiac and metabolic alterations down to changes in renal function. Most of these changes could sustainably change long-term morbidity and mortality of the treated patients, even if blood pressure remains unchanged. Furthermore, a number of promising predictors for a successful treatment with RDN have been identified recently and further trials are ongoing. This will certainly help to improve the preselection of potential candidates for RDN and thereby optimize treatment outcomes. This review summarizes important pathophysiologic effects of renal denervation and illustrates the currently known predictors for therapy success.</description><subject>denervation;Sympathetic</subject><subject>hypertension</subject><subject>nervous</subject><subject>Renal</subject><subject>Review</subject><subject>sympathetic</subject><subject>system;Predictors;Hypertension;Renal</subject><issn>1949-8462</issn><issn>1949-8462</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><recordid>eNpVUU1r3DAUNKUlCUmOuRYde_FWX7akS6GEpg0ECiU9C1l-XivYkiNpt_iUv14t2S6pLprRG40GTVXdELzhjOHPf57sZi83ThbavqsuiOKqlryl79_g8-o6pSdcFucCU3pWnVPRUiIEuahefoE3E0rrvJg8QnYW9eAh7k12wSPnUTmNZllRhORSNj6jcV0gZvCpKOrDtbCMayFT2DpbzExawOaEjO_REqF3NoeY0BAiyhFMnqGYpJ21kNJV9WEwU4Lr435Z_b779nj7o374-f3-9utDbVlLci3BQGN71Qkp-IAFY0piThgVQhE8CGuohJYMZQZdY7EBGHjfNaIDIpht2WX15dV32XUz9LZEiGbSS3SziasOxun_J96Nehv2mislGsqLwaejQQzPO0hZzy5ZmCbjIeySJrJ8OFWNaoq0fpXaGFKKMJyeIVgfetOlN72X2slCD9k-vs12Uv9rqQjY0XAMfvvs_PakkUJwKRVuMJdcNZzLpi2oYPYXXDmpuw</recordid><startdate>20160826</startdate><enddate>20160826</enddate><creator>Fengler, Karl</creator><creator>Rommel, Karl Philipp</creator><creator>Okon, Thomas</creator><creator>Schuler, Gerhard</creator><creator>Lurz, Philipp</creator><general>Baishideng Publishing Group Inc</general><scope>2RA</scope><scope>92L</scope><scope>CQIGP</scope><scope>~WA</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20160826</creationdate><title>Renal sympathetic denervation in therapy resistant hypertension-pathophysiological aspects and predictors for treatment success</title><author>Fengler, Karl ; Rommel, Karl Philipp ; Okon, Thomas ; Schuler, Gerhard ; Lurz, Philipp</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c361t-8eae5cd9b7874f0733980413277910f7ca28e61f4f0eb5c0aeef4db57be173c63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>denervation;Sympathetic</topic><topic>hypertension</topic><topic>nervous</topic><topic>Renal</topic><topic>Review</topic><topic>sympathetic</topic><topic>system;Predictors;Hypertension;Renal</topic><toplevel>online_resources</toplevel><creatorcontrib>Fengler, Karl</creatorcontrib><creatorcontrib>Rommel, Karl Philipp</creatorcontrib><creatorcontrib>Okon, Thomas</creatorcontrib><creatorcontrib>Schuler, Gerhard</creatorcontrib><creatorcontrib>Lurz, Philipp</creatorcontrib><collection>中文科技期刊数据库</collection><collection>中文科技期刊数据库-CALIS站点</collection><collection>中文科技期刊数据库-7.0平台</collection><collection>中文科技期刊数据库- 镜像站点</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>World journal of cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Fengler, Karl</au><au>Rommel, Karl Philipp</au><au>Okon, Thomas</au><au>Schuler, Gerhard</au><au>Lurz, Philipp</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Renal sympathetic denervation in therapy resistant hypertension-pathophysiological aspects and predictors for treatment success</atitle><jtitle>World journal of cardiology</jtitle><addtitle>World Journal of Cardiology</addtitle><date>2016-08-26</date><risdate>2016</risdate><volume>8</volume><issue>8</issue><spage>436</spage><epage>446</epage><pages>436-446</pages><issn>1949-8462</issn><eissn>1949-8462</eissn><abstract>Many forms of human hypertension are associated with an increased systemic sympathetic activity. Especially the renal sympathetic nervous system has been found to play a prominent role in this context. Therefore, catheterinterventional renal sympathetic denervation(RDN) has been established as a treatment for patients suffering from therapy resistant hypertension in the past decade. The initial enthusiasm for this treatment was markedly dampened by the results of the Symplicity-HTN-3 trial, although the transferability of the results into clinical practice to date appears to be questionable. In contrast to the extensive use of RDN in treating hypertensive patients within or without clinical trial settings over the past years, its effects on the complex pathophysiological mechanisms underlying therapy resistant hypertension are only partly understood and are part of ongoing research. Effects of RDN have been described on many levels in human trials: From altered systemic sympathetic activity across cardiac and metabolic alterations down to changes in renal function. Most of these changes could sustainably change long-term morbidity and mortality of the treated patients, even if blood pressure remains unchanged. Furthermore, a number of promising predictors for a successful treatment with RDN have been identified recently and further trials are ongoing. This will certainly help to improve the preselection of potential candidates for RDN and thereby optimize treatment outcomes. This review summarizes important pathophysiologic effects of renal denervation and illustrates the currently known predictors for therapy success.</abstract><cop>United States</cop><pub>Baishideng Publishing Group Inc</pub><pmid>27621771</pmid><doi>10.4330/wjc.v8.i8.436</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
fulltext | fulltext |
identifier | ISSN: 1949-8462 |
ispartof | World journal of cardiology, 2016-08, Vol.8 (8), p.436-446 |
issn | 1949-8462 1949-8462 |
language | eng |
recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_4997524 |
source | Baishideng "World Journal of" online journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central |
subjects | denervation Sympathetic hypertension nervous Renal Review sympathetic system Predictors Hypertension Renal |
title | Renal sympathetic denervation in therapy resistant hypertension-pathophysiological aspects and predictors for treatment success |
url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-25T14%3A47%3A40IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Renal%20sympathetic%20denervation%20in%20therapy%20resistant%20hypertension-pathophysiological%20aspects%20and%20predictors%20for%20treatment%20success&rft.jtitle=World%20journal%20of%20cardiology&rft.au=Fengler,%20Karl&rft.date=2016-08-26&rft.volume=8&rft.issue=8&rft.spage=436&rft.epage=446&rft.pages=436-446&rft.issn=1949-8462&rft.eissn=1949-8462&rft_id=info:doi/10.4330/wjc.v8.i8.436&rft_dat=%3Cproquest_pubme%3E1819429595%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1819429595&rft_id=info:pmid/27621771&rft_cqvip_id=87748890504849544856484849&rfr_iscdi=true |