Effect of renal denervation on catecholamines and the renin-angiotensin-aldosterone system.

IF 2.1 4区 医学 Q3 PERIPHERAL VASCULAR DISEASE Journal of the Renin-Angiotensin-Aldosterone System Pub Date : 2020-07-01 DOI:10.1177/1470320320943095
Lida Feyz, Sjoerd van den Berg, Robert Zietse, Isabella Kardys, Jorie Versmissen, Joost Daemen
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引用次数: 10

Abstract

Introduction: The effect of renal sympathetic denervation (RDN) on neurohormonal responses is largely unknown. We aimed to assess the effect of RDN on the renin-angiotensin-aldosterone system (RAAS) and endogenous catecholamines.

Methods: A total of 60 patients with hypertension underwent RDN and remained on a stable antihypertensive drug regimen. Samples for plasma aldosterone, plasma renin and urine (nor)metanephrine were collected at baseline and at 6 months post procedure. Ambulatory blood pressure (BP) recordings were obtained at baseline and at 6 months post procedure.

Results: Mean age was 64±9 years, and 30/60 patients were male. At 6 months, average daytime systolic and diastolic ambulatory BP decreased by 10 and 6 mmHg, respectively (p<0.001). No significant change was observed in plasma aldosterone (median=248.0 pmol/L (interquartile range (IQR) 113.3-369.5 pmol/L) vs. median=233.0 pmol/L (IQR 110.3-360.8 pmol/L); p=0.66); renin (median=19.5 µIU/mL (IQR 6.8-119.5 µIU/mL) vs. median=14.3 µIU/mL (IQR 7.2-58.0 µIU/mL); p=0.32), urine metanephrine (median=0.46 µmol/L (IQR 0.24-0.77 µmol/L) vs. median=0.46 µmol/L (IQR 0.22-0.88 µmol/L); p=0.75) and normetanephrine (median=1.41 µmol/L (IQR 0.93-2.00 µmol/L vs. median =1.56 (IQR 0.74-2.50 µmol/L); p=0.58) between baseline and 6 months, respectively. No correlation was found between the decrease in mean systolic daytime BP and changes in RAAS hormones or endogenous catecholamines.

Conclusion: Despite significant reductions in ambulatory BP, RDN did not result in a significant change in endogenous catecholamines or in RAAS hormones at 6 months.

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肾去神经支配对儿茶酚胺和肾素-血管紧张素-醛固酮系统的影响。
导读:肾交感神经断神经(RDN)对神经激素反应的影响在很大程度上是未知的。我们旨在评估RDN对肾素-血管紧张素-醛固酮系统(RAAS)和内源性儿茶酚胺的影响。方法:60例高血压患者接受RDN治疗,并保持稳定的降压药物治疗方案。在基线和术后6个月收集血浆醛固酮、血浆肾素和尿(非)肾上腺素样本。在基线和手术后6个月获得动态血压(BP)记录。结果:患者平均年龄64±9岁,男性30/60。6个月时,平均日间收缩压和舒张压分别下降10和6 mmHg (pp=0.66);肾素(中位数=19.5µIU/mL (IQR 6.8-119.5µIU/mL) vs中位数=14.3µIU/mL (IQR 7.2-58.0µIU/mL);p=0.32),尿肾上腺素(中位数=0.46µmol/L (IQR 0.24-0.77µmol/L) vs中位数=0.46µmol/L (IQR 0.22-0.88µmol/L);p=0.75)和去甲肾上腺素(中位数=1.41µmol/L (IQR 0.93-2.00µmol/L vs.中位数=1.56 (IQR 0.74-2.50µmol/L);P =0.58)。白天平均收缩压的降低与RAAS激素或内源性儿茶酚胺的变化没有相关性。结论:尽管动态血压显著降低,但在6个月时,RDN并未导致内源性儿茶酚胺或RAAS激素的显著变化。
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来源期刊
CiteScore
6.20
自引率
0.00%
发文量
16
审稿时长
6-12 weeks
期刊介绍: JRAAS is a peer-reviewed, open access journal, serving as a resource for biomedical professionals, primarily with an active interest in the renin-angiotensin-aldosterone system in humans and other mammals. It publishes original research and reviews on the normal and abnormal function of this system and its pharmacology and therapeutics, mostly in a cardiovascular context but including research in all areas where this system is present, including the brain, lungs and gastro-intestinal tract.
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