effects of renal sympathetic denervation

Annals of Medicine

ISSN: 0785-3890 (Print) 1365-2060 (Online) Journal homepage: http://www.tandfonline.com/loi/iann20

PLASMA ENDOTHELIN-1 LEVELS IN PATIENTS WITH RESISTANT HYPERTENSION: EFFECTS OF RENAL SYMPATHETIC DENERVATION Luigi Petramala, Federica Olmati, Massimo Mancone, Antonio Concistré, Matteo Galassi, Cristiano Marinelli, Gianfranco Tonnarini, Piernatale Lucia, Umberto Costi, Gino Iannucci, Gennaro Sardella & Claudio Letizia To cite this article: Luigi Petramala, Federica Olmati, Massimo Mancone, Antonio Concistré, Matteo Galassi, Cristiano Marinelli, Gianfranco Tonnarini, Piernatale Lucia, Umberto Costi, Gino Iannucci, Gennaro Sardella & Claudio Letizia (2017): PLASMA ENDOTHELIN-1 LEVELS IN PATIENTS WITH RESISTANT HYPERTENSION: EFFECTS OF RENAL SYMPATHETIC DENERVATION, Annals of Medicine, DOI: 10.1080/07853890.2017.1282623 To link to this article: http://dx.doi.org/10.1080/07853890.2017.1282623

Accepted author version posted online: 13 Jan 2017.

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Date: 14 January 2017, At: 14:13

PLASMA

ENDOTHELIN-1

LEVELS

IN

PATIENTS

WITH

RESISTANT

HYPERTENSION: EFFECTS OF RENAL SYMPATHETIC DENERVATION

Running title: renal sympathetic denervation and endothelin-1

Luigi Petramala*, Federica Olmati*, Massimo Mancone**, Antonio Concistré*, Matteo Galassi *, Cristiano Marinelli*, Gianfranco Tonnarini*, Piernatale Lucia*, Umberto Costi***, Gino Iannucci*,

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Gennaro Sardella** and Claudio Letizia*.

*

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Specialized Center of Secondary Hypertension, Department of Internal Medicine and Medical

Specialties, and **Department of Cardiovascular, Respiratory, Nephrology, Anestesiology and

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Geriatric Sciences, ***Department of Surgery “P. Valdoni”, Policlinico “Umberto I”, University of

ST

Correspondence to:

AC

C

Rome “Sapienza”, Rome, Italy

Prof. Claudio Letizia, M.D.

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Department of Internal Medicine and Medical Specialties Policlinico “Umberto I”, University “La Sapienza”, Rome, 00155 Rome, Italy E-mail: [email protected]

ABSTRACT Introduction: Resistant arterial hypertension (RHT) is defined as poor controlled blood pressure (BP) despite optimal doses of 3 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 (ET1) 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).

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Results: After 12 months of the RSD, we observed a significant reduction of BP office, 24-hr

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ambulatory BP monitoring (ABPM) (p