Author + information
- Received March 7, 2019
- Revision received April 10, 2019
- Accepted April 15, 2019
- Published online June 10, 2019.
- Márcio G. Kiuchi, MD, MSc, PhDa,
- Murray D. Esler, MBBS, PhDb,
- Gregory D. Fink, PhDc,
- John W. Osborn, PhDd,
- Christopher T. Banek, PhDd,
- Michael Böhm, MDe,
- Kate M. Denton, PhDf,
- Gerald F. DiBona, MDg,
- Thomas H. Everett IV, PhDh,
- Guido Grassi, MDi,
- Richard E. Katholi, MDj,
- Mark M. Knuepfer, PhDk,
- Ulla C. Kopp, PhDl,
- David J. Lefer, PhDm,
- Thomas E. Lohmeier, PhDn,
- Clive N. May, PhDo,
- Felix Mahfoud, MDe,
- Julian F.R. Paton, PhDp,q,
- Roland E. Schmieder, MDr,
- Peter R. Pellegrino, PhDs,
- Yehonatan Sharabi, MDt and
- Markus P. Schlaich, MDa,b,∗ (, )@markus_schlaich
- aDobney Hypertension Centre, School of Medicine–Royal Perth Hospital Unit, University of Western Australia and Departments of Cardiology and Nephrology, Royal Perth Hospital, Perth, Australia
- bNeurovascular Hypertension & Kidney Disease Laboratory and Human Neurotransmitter Laboratory, Baker Heart and Diabetes Institute, Melbourne, Australia
- cDepartment of Pharmacology and Toxicology, Michigan State University, East Lansing, Michigan
- dDepartment of Integrative Biology and Physiology, University of Minnesota, Minneapolis, Minnesota
- eKlinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Saarland University, Homburg/Saar, Germany
- fCardiovascular Program, Monash Biomedicine Discovery Institute and Department of Physiology, Monash University, Melbourne, Victoria, Australia
- gDepartment of Internal Medicine and Molecular Physiology and Biophysics, University of Iowa, Carver College of Medicine, Iowa City, Iowa
- hThe Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana
- iClinica Medica, Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
- jPrairie Heart Institute at St. John's Hospital, Department of Cardiology, Springfield, Illinois
- kDepartment of Pharmacology and Physiology, St. Louis University School of Medicine, St. Louis, Missouri
- lDepartments of Internal Medicine and Pharmacology, University of Iowa Carver College of Medicine, Iowa City, Iowa
- mCardiovascular Center of Excellence and Department of Pharmacology, LSU Health Science Center, New Orleans, Louisiana
- nDepartment of Physiology and Biophysics, University of Mississippi Medical Center, Jackson, Missouri
- oThe Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
- pDepartment of Physiology, Faculty of Medical and Health Sciences, University of Auckland, New Zealand
- qSchool of Physiology, Pharmacology & Neuroscience, Biomedical Sciences, University of Bristol, Bristol, United Kingdom
- rDepartment of Nephrology and Hypertension, University Hospital of the University Erlangen-Nuremberg, Erlangen, Germany
- sDepartments of Anesthesiology and Cellular and Integrative Physiology, University of Nebraska Medical Center, Omaha, Nebraska
- tChaim Sheba Medical Center and Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel
- ↵∗Address for correspondence:
Dr. Markus P. Schlaich, School of Medicine-Royal Perth Hospital Unit, The University of Western Australia, Level 3, MRF Building, Rear 50 Murray Street, Perth WA 6000, Australia.
• Sympathetic nervous system activation is a key contributor to elevated BP.
• Catheter-based RDN reduces BP in both treated and drug naïve patients.
• Improved trial design, patient selection, and optimized procedural approaches contributed to these positive findings.
• Future research will focus on reducing the variability of the BP response and indications beyond hypertension.
Three recent renal denervation studies in both drug-naïve and drug-treated hypertensive patients demonstrated a significant reduction of ambulatory blood pressure compared with respective sham control groups. Improved trial design, selection of relevant patient cohorts, and optimized interventional procedures have likely contributed to these positive findings. However, substantial variability in the blood pressure response to renal denervation can still be observed and remains a challenging and important problem. The International Sympathetic Nervous System Summit was convened to bring together experts in both experimental and clinical medicine to discuss the current evidence base, novel developments in our understanding of neural interplay, procedural aspects, monitoring of technical success, and others. Identification of relevant trends in the field and initiation of tailored and combined experimental and clinical research efforts will help to address remaining questions and provide much-needed evidence to guide clinical use of renal denervation for hypertension treatment and other potential indications.
All authors received honoraria and travel support from Medtronic to present at “The SNS Summit” held in Barcelona in June 2018. Dr. Esler has been supported in part by the Victorian Government’s Operational Infrastructure Support Program; has received salary support from an Australian Government NHMRC Senior Principal Research Fellowship; and has been a member of the Advisory Boards of SyMap and Medtronic. Dr. Banek is supported by National Institutes of Health grant K99 HL141650. Drs. Böhm and Mahfoud are supported by Deutsche Gesellschaft für Kardiologie, Deutsche Hochdruckliga, and Deutsche Forschungsgemeinschaft (SFB TRR 219); and have received grant support and personal fees from Medtronic and Recor Medical. Dr. Böhm has received research support and speaker fees from Abbott, Amgen, AstraZeneca, Bayer, Boehringer Ingelheim, Servier, Medtronic, Vifor, and Novartis. Dr. Denton is supported by an NHMRC research fellowship; and has received travel support from Medtronic. Dr. Everett is supported in part by National Institutes of Health grant R42DA043391 and a Charles Fisch Cardiovascular Research Award endowed by Dr. Suzanne B. Knoebel of the Krannert Institute of Cardiology. Dr. Mahfoud has received research grants from and served on the Speakers Bureau of Medtronic and Recor. Dr. Paton was supported by the British Heart Foundation and the Health Research Council of New Zealand. Dr. Schmieder has received speaker fees, consultancy, and advisory board fees from Ablative Solutions, Medtronic, Recor, and ROX Medical. Dr. Pellegrino has received honoraria and travel support from Medtronic. Dr. Schlaich is supported by an NHMRC Research Fellowship; and has received consulting fees and/or travel and research support from Medtronic, Abbott, Novartis, Servier, Pfizer, and Boehringer Ingelheim. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Listen to this manuscript's audio summary by Editor-in-Chief Dr. Valentin Fuster on JACC.org.
- Received March 7, 2019.
- Revision received April 10, 2019.
- Accepted April 15, 2019.
- 2019 American College of Cardiology Foundation
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