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Renal Denervation: For the Prevention of Heart Failure in Hypertensive Patients

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Hypertension and Heart Failure

Part of the book series: Updates in Hypertension and Cardiovascular Protection ((UHCP))

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Abstract

Uncontrolled hypertension is considered as one of the most important cardiovascular risk factors. Recently, catheter-based techniques using mainly radiofrequency or thermal energy brought to light the concept of renal denervation (RDN) as a viable therapeutic option in cardiovascular medicine. During the last decade, several single-arm studies have shown significant reduction in blood pressure among patients with uncontrolled hypertension. Although the early proof of concept studies showed a surprisingly great blood pressure reduction with RDN, the largest sham-controlled study (SYMPLICITY HTN-3) failed to confirm similar findings. Since then, both basic and clinical research took place and results have been taken into consideration careful design of modern devices and procedures used in the RDN era.

Prospective observational studies have suggested that RDN is associated with target organ damage (TOD) regression. Thus, in this chapter we present a systematic review and meta-analysis, which evaluates the effect of RDN on target organ damage by pooling currently available data and investigates its relation to BP-lowering following RDN. Seventeen studies (n = 698 patients) were incorporated in the present meta-analysis thus examining the following outcomes of interest: left ventricular mass index (LVMI), left atrial volume index (LAVI), E to A wave velocities of trans-mitral inflow (E/A) and E wave velocity to Em velocity from tissue Doppler imaging (E/Em), central augmentation index (AIx), and carotid−femoral pulse wave velocity (PWV). It is of great concern that the improvement of the abovementioned factors concerning left ventricle after RDN might play a crucial role in the prevention of heart failure in hypertensive patients.

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Authors and Affiliations

  1. National and Kapodistrian University, Athens, Greece

    Konstantinos Tsioufis, Fotis Tatakis & Panagiotis Tsioufis

  2. Georgetown University and VA Medical Center, Washington, DC, USA

    Konstantinos Tsioufis

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  1. Konstantinos Tsioufis
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  2. Fotis Tatakis
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  3. Panagiotis Tsioufis
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Editors and Affiliations

  1. Carol Davila University of Medicine and Pharmacy, Bucharest, Bucuresti, Romania

    Maria Dorobantu

  2. Department of Pharmacology, Toxicology and Clinical Psychopharmacology Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania

    Victor Voicu

  3. University of Milano-Bicocca, Milano, Italy

    Guido Grassi

  4. Dept of Clinical and Experimental Sci, University of Brescia, Brescia, Italy

    Enrico Agabiti-Rosei

  5. University of Milano-Bicocca, Milano, Italy

    Giuseppe Mancia

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Tsioufis, K., Tatakis, F., Tsioufis, P. (2023). Renal Denervation: For the Prevention of Heart Failure in Hypertensive Patients. In: Dorobantu, M., Voicu, V., Grassi, G., Agabiti-Rosei, E., Mancia, G. (eds) Hypertension and Heart Failure. Updates in Hypertension and Cardiovascular Protection. Springer, Cham. https://doi.org/10.1007/978-3-031-39315-0_28

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  • DOI: https://doi.org/10.1007/978-3-031-39315-0_28

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