Author + information
- Dörr Oliver,
- Christoph Liebetrau,
- Helge Möllmann,
- Daniel Sedding,
- Johannes Rixe,
- Christian Troidl,
- Franziska Hecker,
- Sebastian Szardien,
- Matthias Willmer,
- Christian Hamm and
- Holger Nef
Renal sympathetic denervation (RSD) represents a treatment option for patients with resistant arterial hypertension (HT). However, in several patients (8-13%) even RSD is without any effect. Predicting parameters have not yet been described in detail for these non-responders. The angiogenetic factor soluble fms-like tyrosine kinase-1 (sFLT-1) is associated with endothelial dysfunction, vascular remodeling, and HT. Therefore, in the present study we aimed to examine, whether sFLT-1 is a predictive marker for blood pressure reduction after RSD.
A total of 30 consecutive patients (age:62.5±12.2y) were included to this study. We compared the serum levels of sFLT-1 of responders and non-responders. A non-responder (n=9) was defined as an unsuccessful blood pressure reduction of <10 mmHg after 6 months. Serum samples were collected prior and after 6 months.
Significant systolic blood pressure (BP) reduction of 29.6 [±8.9] mmHg (p<0.01) was documented in 21 patients in the 24-h ambulatory blood pressure monitoring 6 months after procedure. 9 patients were classified as non-responders with a mean systolic BP reduction of 7.1 [±1.49] mmHg. sFLT-1 baseline levels of responders were significantly higher as compared to non-responders (sFLT-responders: 143 pg/ml [117;176] vs. non-responders: 110[77;135] ng/ml;p<0.001). In responders a reduction of the sFLT-1 levels was measured after 6 months. In contrast, non-responders showed an increase of the sFLT-1 (responders: −11.7 pg/ml [−41.4;14.1] vs. non-responders:35.8 [9.5;53.9] pg/ml; p<0.001). Additionally, we performed a ROC analysis calculating the predictive value of sFLT serum levels at baseline as a marker for adequate BP reduction after RSD (AUC 0.77 [0.648;0.895]; p<0.001).
Even RSD is an effective therapy option for resistant HT several patients do not respond for not yet clarified reasons. In this study, responders showed significantly increased serum levels of the angiogenetic factor sFLT-1 at baseline in comparison to non-responders. Thus, this study identified for the first time a potential biomarker with a predictive value indicating a responder or non-responder after RSD.
Poster Sessions, Expo North
Saturday, March 09, 2013, 3:45 p.m.-4:30 p.m.
Session Title: Renal Denervation: Coming of Age
Abstract Category: 25. Prevention: Hypertension
Presentation Number: 1148-21
- 2013 American College of Cardiology Foundation