ABSTRACT Introduction: 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. Material and methods: 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). Results: 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 ¼ 0.004; at left from 22.1 ± 3.7 to 18.9 ± 3.3 pg/ml; p ¼ 0.02). We observed positive correlations between plasma renal arteries ET-1 levels and systolic BP values at ABPM [Global-SBP (r¼ 0.58; p < 0.01), Diurnal-SBP (r ¼ 0.51; p < 0.03) and Nocturnal-SBP (r ¼ 0.58; p < 0.01), respectively]. Discussion: 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.

Plasma endothelin-1 levels in patients with resistant hypertension. effects of renal sympathetic denervation / Mancone, Massimo; Petramala, Luigi; Olmati, Federica; Concistrè, Antonio; Galassi, Matteo; Marinelli, Cristiano; Tonnarini, Gianfranco; Lucia, Piernatale; Costi, Umberto; Iannucci, Gino; Sardella, Gennaro; Letizia, Claudio. - In: ANNALS OF MEDICINE. - ISSN 0785-3890. - STAMPA. - 49:5(2017), pp. 396-403. [10.1080/07853890.2017.1282623]

Plasma endothelin-1 levels in patients with resistant hypertension. effects of renal sympathetic denervation

Mancone Massimo;Petramala Luigi;Federica Olmati;Concistrè Antonio;Tonnarini Gianfranco;Piernatale Lucia;Costi Umberto;Iannucci Gino;Sardella gennaro;
2017

Abstract

ABSTRACT Introduction: 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. Material and methods: 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). Results: 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 ¼ 0.004; at left from 22.1 ± 3.7 to 18.9 ± 3.3 pg/ml; p ¼ 0.02). We observed positive correlations between plasma renal arteries ET-1 levels and systolic BP values at ABPM [Global-SBP (r¼ 0.58; p < 0.01), Diurnal-SBP (r ¼ 0.51; p < 0.03) and Nocturnal-SBP (r ¼ 0.58; p < 0.01), respectively]. Discussion: 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.
2017
ambulatory blood pressure monitoring; endothelin-1; office blood pressure; renal sympathetic denervation; resistant arterial hypertension; medicine (all)
01 Pubblicazione su rivista::01a Articolo in rivista
Plasma endothelin-1 levels in patients with resistant hypertension. effects of renal sympathetic denervation / Mancone, Massimo; Petramala, Luigi; Olmati, Federica; Concistrè, Antonio; Galassi, Matteo; Marinelli, Cristiano; Tonnarini, Gianfranco; Lucia, Piernatale; Costi, Umberto; Iannucci, Gino; Sardella, Gennaro; Letizia, Claudio. - In: ANNALS OF MEDICINE. - ISSN 0785-3890. - STAMPA. - 49:5(2017), pp. 396-403. [10.1080/07853890.2017.1282623]
File allegati a questo prodotto
File Dimensione Formato  
Petramala_ Plasma_2017.pdf

solo gestori archivio

Tipologia: Versione editoriale (versione pubblicata con il layout dell'editore)
Licenza: Tutti i diritti riservati (All rights reserved)
Dimensione 1.19 MB
Formato Adobe PDF
1.19 MB Adobe PDF   Contatta l'autore

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11573/966111
Citazioni
  • ???jsp.display-item.citation.pmc??? 1
  • Scopus 5
  • ???jsp.display-item.citation.isi??? 4
social impact