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Renal denervation (RDN) is a promising new treatment option. Only 70% of patients have a relevant reduction in blood pressure (BP) three to six months after RDN when assessed by systematic 24h BP measurements. No variables have been identified to date predicting the BP response.
We assessed 14 patients with bilateral renal denervation for the changes of pre– and postprocedural norepinephrine (NE) and epinephrine (E) levels measured directly from the renal artery (RA) and vein (RV). We defined the respective spillover for ΔNE and ΔE as the difference RV–RA and compared this difference before and after the procedure.
We assessed NE and E for 112 probes (14 patients × 2 (bilateral probes) × 2(RA and RV) × 2(pre– and post–procedural)). There was a significant decrease of the ΔNE RV–RA spill–over comparing pre– with post–procedural levels (189pg/ml±170 decrease to 91pg/ml±122, P=0.03 for paired t–test). There was no significant change in the epinephrine levels during the procedure under conscious sedation (54pg/ml±177 compared to 34pg/ml±161, P=0.71 for paired t–test). The pre–post ΔNE RV–RA was even more pronounced when the median values were compared (P = 0.02).
The decrease of norepinephrine veno–arterial difference during RDN is a readily assessable marker reflecting the disconnection of renal sympathetic nerves. The systematic follow–up of our patients will allow the evaluation of the prognostic value of norepinephrine spillover decrease with the BP response.
West, Room 2009
Sunday, March 10, 2013, 8:15 a.m.–8:25 a.m.
Session Title: Endovascular Intervention and Renal Denervation
Abstract Category: 41. TCT@ACC–i2: Carotid, Neurovascular, and Endovascular Intervention
Presentation Number: 2905–3
- 2013 American College of Cardiology Foundation