Potential future denervation targets

Kui Toh Gerard Leong; Antony Walton; Henry Krum; Markus P. Schlaich

doi:10.2217/ica.14.60

Potential future denervation targets

Kui Toh Gerard Leong, Antony Walton, Henry Krum, Markus P. Schlaich

Internal Medicine

Research output: Contribution to journal › Article › peer-review

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Abstract

The human sympathetic nervous system has an important regulatory role. In its dysfunctional hyperexcitatory state, it can lead to multiple pathologies. The renal sympathetic nerves play a significant role in these pathological states. Percutaneous renal sympathetic denervation (RSDN) allows for safe minimally invasive selective denervation of the renal sympathetic nerves. RSDN has been shown to be safe and efficacious in blood pressure reduction in earlier nonblinded SYMPLICITY HTN-1 and -2 trials. In Europe, it is approved for a select group of truly resistant severe essential hypertension. However, its real efficacy is now in doubt with the blinded SYMPLICITY HTN-3 trial that showed no significant difference in change in office and mean 24-h ambulatory systolic blood pressure between RSDN and sham-procedure arms. This review will look at the potential targets for percutaneous RSDN-heart failure, cardiac arrhythmias and kidney disease, sleep-disordered breathing and insulin resistance.

Original language	English
Pages (from-to)	569-579
Number of pages	11
Journal	Interventional Cardiology
Volume	6
Issue number	6
DOIs	https://doi.org/10.2217/ica.14.60
Publication status	Published - 1 Dec 2014

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title = "Potential future denervation targets",

abstract = "The human sympathetic nervous system has an important regulatory role. In its dysfunctional hyperexcitatory state, it can lead to multiple pathologies. The renal sympathetic nerves play a significant role in these pathological states. Percutaneous renal sympathetic denervation (RSDN) allows for safe minimally invasive selective denervation of the renal sympathetic nerves. RSDN has been shown to be safe and efficacious in blood pressure reduction in earlier nonblinded SYMPLICITY HTN-1 and -2 trials. In Europe, it is approved for a select group of truly resistant severe essential hypertension. However, its real efficacy is now in doubt with the blinded SYMPLICITY HTN-3 trial that showed no significant difference in change in office and mean 24-h ambulatory systolic blood pressure between RSDN and sham-procedure arms. This review will look at the potential targets for percutaneous RSDN-heart failure, cardiac arrhythmias and kidney disease, sleep-disordered breathing and insulin resistance.",

keywords = "cardiac arrhythmia, heart failure, insulin resistance, kidney disease, renal sympathetic denervation, resistant hypertension, sleep-disordered breathing, sympathetic nervous system",

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AU - Gerard Leong, Kui Toh

AU - Walton, Antony

AU - Krum, Henry

AU - Schlaich, Markus P.

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N2 - The human sympathetic nervous system has an important regulatory role. In its dysfunctional hyperexcitatory state, it can lead to multiple pathologies. The renal sympathetic nerves play a significant role in these pathological states. Percutaneous renal sympathetic denervation (RSDN) allows for safe minimally invasive selective denervation of the renal sympathetic nerves. RSDN has been shown to be safe and efficacious in blood pressure reduction in earlier nonblinded SYMPLICITY HTN-1 and -2 trials. In Europe, it is approved for a select group of truly resistant severe essential hypertension. However, its real efficacy is now in doubt with the blinded SYMPLICITY HTN-3 trial that showed no significant difference in change in office and mean 24-h ambulatory systolic blood pressure between RSDN and sham-procedure arms. This review will look at the potential targets for percutaneous RSDN-heart failure, cardiac arrhythmias and kidney disease, sleep-disordered breathing and insulin resistance.

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KW - cardiac arrhythmia

KW - heart failure

KW - insulin resistance

KW - kidney disease

KW - renal sympathetic denervation

KW - resistant hypertension

KW - sleep-disordered breathing

KW - sympathetic nervous system

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Potential future denervation targets

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