Interv Akut Kardiol. 2022;21(4):208-215 | DOI: 10.36290/kar.2022.024

Role of renal sympathetic denervation in non­‑pharmacological treatment of cardiovascular diseases

Alan Bulava
Kardiocentrum, Nemocnice České Budějovice, a. s.
Zdravotně sociální fakulta Jihočeské univerzity v Českých Budějovicích
Lékařská fakulta Univerzity Palackého v Olomouci

Renal sympathetic denervation (RDN) is a method that has experienced its rise and fall in the treatment of pharmacologically-resistant essential arterial hypertension, and its firm indications for the treatment of this disease have not been defined yet. Modification of sympathetic activity, however, is in the centre of attention in the treatment of some other pathological conditions. From the pathophysiologic point of view, it is certainly so in the treatment of heart failure, atrial fibrillation, and some types of ventricular arrhythmias, as well as in the case of some other diseases, to a greater or lesser extent. The aim of this article is to review the present knowledge on the contribution of RDN in the treatment of the above-mentioned diseases.

Keywords: renal denervation, sympathetic nervous system, non­‑pharmacological treatment, heart failure, arrhythmias.

Received: August 21, 2022; Revised: August 21, 2022; Accepted: October 18, 2022; Published: December 19, 2022  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Bulava A. Role of renal sympathetic denervation in non­‑pharmacological treatment of cardiovascular diseases. Interv Akut Kardiol. 2022;21(4):208-215. doi: 10.36290/kar.2022.024.
Download citation

References

  1. Krum H, Schlaich MP, Sobotka PA, et al. Percutaneous renal denervation in patients with treatment­‑resistant hypertension: final 3-year report of the Symplicity HTN-1 study. Lance. 2014;383:622-629. Go to original source... Go to PubMed...
  2. Esler MD, Krum H, Sobotka PA, et al. Renal sympathetic denervation in patients with treatment­‑resistant hypertension (The Symplicity HTN-2 Trial): a randomised controlled trial. Lancet. 2010;376:1903-1909. Go to original source... Go to PubMed...
  3. Böhm M, Mahfoud F, Ukena C, et al. First Report of the Global SYMPLICITY Registry on the Effect of Renal Artery Denervation in Patients With Uncontrolled Hypertension. Hypertension. 2015;65:766-774. Go to original source... Go to PubMed...
  4. Morrissey DM, Brookes V, Cooke WT. Sympathectomy in the treatment of hypertension: review of 122 cases. Lancet. 1953;261:403-408. Go to original source... Go to PubMed...
  5. Bhatt DL, Kandzari DE, O'Neill WW, et al. A Controlled Trial of Renal Denervation for Resistant Hypertension. New Engl J Medicine. 2014;370:1393-1401. Go to original source... Go to PubMed...
  6. Townsend RR, Mahfoud F, Kandzari DE, et al. Catheter­‑based renal denervation in patients with uncontrolled hypertension in the absence of antihypertensive medications (SPYRAL HTN­‑OFF MED): a randomised, sham­‑controlled, proof­‑of­‑concept trial. Lancet. 2017;390:2160-2170. Go to original source... Go to PubMed...
  7. Kandzari DE, Böhm M, Mahfoud F, et al. Effect of renal denervation on blood pressure in the presence of antihypertensive drugs: 6-month efficacy and safety results from the SPYRAL HTN­‑ON MED proof­‑of­‑concept randomised trial. Lancet. 2018;391:2346-2355. Go to original source... Go to PubMed...
  8. Azizi M, Schmieder RE, Mahfoud F, et al. Endovascular ultrasound renal denervation to treat hypertension (RADIANCE­‑HTN SOLO): a multicentre, international, single­‑blind, randomised, sham­‑controlled trial. Lancet. 2018;391:2335-2345. Go to original source... Go to PubMed...
  9. Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018;39:3021-3104. Go to original source... Go to PubMed...
  10. Schmieder RE, Mahfoud F, Mancia G, et al. European Society of Hypertension position paper on renal denervation 2021. J Hypertens. 2021;39:1733-1741. Go to original source... Go to PubMed...
  11. Schlaich MP, Sobotka PA, Krum H, et al. Renal Sympathetic­‑Nerve Ablation for Uncontrolled Hypertension. New Engl J Medicine. 2009;361:932-934. Go to original source... Go to PubMed...
  12. Sakakura K, Ladich E, Cheng Q, et al. Anatomic Assessment of Sympathetic Peri­‑Arterial Renal Nerves in Man. J Am Coll Cardiol. 2014;64:635-643. Go to original source... Go to PubMed...
  13. Mompeo B, Maranillo E, Garcia-Touchard A, et al. The gross anatomy of the renal sympathetic nerves revisited. Clin Anat. 2016;29:660-664. Go to original source... Go to PubMed...
  14. Henegar JR, Zhang Y, Hata C, et al. Catheter­‑Based Radiofrequency Renal Denervation: Location Effects on Renal Norepinephrine. Am J Hypertens. 2015;28:909-914. Go to original source... Go to PubMed...
  15. Fengler K, Rommel K­‑P, Blazek S, et al. A Three­‑Arm Randomized Trial of Different Renal Denervation Devices and Techniques in Patients With Resistant Hypertension (RADIOSOUND­‑HTN). Circulation. 2019;139:590-600. Go to original source... Go to PubMed...
  16. Kario K, Yokoi Y, Okamura K, et al. Catheter­‑based ultrasound renal denervation in patients with resistant hypertension: the randomized, controlled REQUIRE trial. Hypertens Res. 2022;45:221-231. Go to original source... Go to PubMed...
  17. Azizi M, Sanghvi K, Saxena M, et al. Ultrasound renal denervation for hypertension resistant to a triple medication pill (RADIANCE­‑HTN TRIO): a randomised, multicentre, single­‑blind, sham­‑controlled trial. Lancet. 2021;397:2476-2486. Go to original source... Go to PubMed...
  18. Neuzil P, Ormiston J, Brinton TJ, et al. Externally Delivered Focused Ultrasound for Renal Denervation. Jacc Cardiovasc Interventions. 2016;9:1292-1299. Go to original source... Go to PubMed...
  19. Chinushi M, Izumi D, Iijima K, et al. Blood Pressure and Autonomic Responses to Electrical Stimulation of the Renal Arterial Nerves Before and After Ablation of the Renal Artery. Hypertension. 2018;61:450-456. Go to original source... Go to PubMed...
  20. Gal P, Jong MRd, Smit JJJ, et al. Blood pressure response to renal nerve stimulation in patients undergoing renal denervation: a feasibility study. J Hum Hypertens. 2015;29:292-295. Go to original source... Go to PubMed...
  21. Jong MRd, Adiyaman A, Gal P, et al. Renal Nerve Stimulation-Induced Blood Pressure Changes Predict Ambulatory Blood Pressure Response After Renal Denervation. Hypertension. 2016;68:707-714. Go to original source... Go to PubMed...
  22. Kaye DM, Lambert GW, Lefkovits J, et al. Neurochemical evidence of cardiac sympathetic activation and increased central nervous system norepinephrine turnover in severe congestive heart failure. J Am Coll Cardiol. 1994;23:570-578. Go to original source... Go to PubMed...
  23. Petersson M, Friberg P, Eisenhofer G, et al. Long­‑term outcome in relation to renal sympathetic activity in patients with chronic heart failure. Eur Heart J. 2005;26:906-913. Go to original source... Go to PubMed...
  24. Nammas W, Koistinen J, Paana T, et al. Renal sympathetic denervation for treatment of patients with heart failure: summary of the available evidence. Ann Med. 2017;49:1-28. Go to original source... Go to PubMed...
  25. Davies JE, Manisty CH, Petraco R, et al. First­‑in­‑man safety evaluation of renal denervation for chronic systolic heart failure: Primary outcome from REACH­‑Pilot study. Int J Cardiol. 2013;162:189-192. Go to original source... Go to PubMed...
  26. Chen W, Ling Z, Xu Y, et al. Preliminary effects of renal denervation with saline irrigated catheter on cardiac systolic function in patients with heart failure: A prospective, randomized, controlled, pilot study. Catheter Cardio Inte. 2017;89:E153-E161. Go to original source... Go to PubMed...
  27. Coumel P, Attuel P, Lavallée J, et al. [The atrial arrhythmia syndrome of vagal origin]. Arch Mal Coeur Vaiss. 1978;71:645-656. Go to PubMed...
  28. Nammas W, Airaksinen JKE, Paana T, et al. Renal sympathetic denervation for treatment of patients with atrial fibrillation: Reappraisal of the available evidence. Heart Rhythm. 2016;13:2388-2394. Go to original source... Go to PubMed...
  29. Tsai W­‑C, Chan Y­‑H, Chinda K, et al. Effects of renal sympathetic denervation on the stellate ganglion and brain stem in dogs. Heart Rhythm. 2017;14:255-262. Go to original source... Go to PubMed...
  30. Vollmann D, Sossalla S, Schroeter MR, et al. Renal artery ablation instead of pulmonary vein ablation in a hypertensive patient with symptomatic, drug­‑resistant, persistent atrial fibrillation. Clin Res Cardiol. 2013;102:315-318. Go to original source... Go to PubMed...
  31. Zhao Q, Yu SB, Xiao JP, et al. Effects of renal sympathetic denervation on the development of atrial fibrillation substrates in dogs with pacing­‑induced heart failure. Eur Heart J. 2013;34:3709-3709. Go to original source...
  32. Wang X, Zhao Q, Deng H, et al. Effects of Renal Sympathetic Denervation on the Atrial Electrophysiology in Dogs with Pacing-Induced Heart Failure. Pacing Clin Electrophysiol. 2014;37:1357-1366. Go to original source... Go to PubMed...
  33. Wang X, Huang C, Zhao Q, et al. Effect of renal sympathetic denervation on the progression of paroxysmal atrial fibrillation in canines with long­‑term intermittent atrial pacing. Ep Europace. 2015;17:647-654. Go to original source... Go to PubMed...
  34. Pokushalov E, Romanov A, Corbucci G, et al. A Randomized Comparison of Pulmonary Vein Isolation With Versus Without Concomitant Renal Artery Denervation in Patients With Refractory Symptomatic Atrial Fibrillation and Resistant Hypertension. J Am Coll Cardiol. 2012;60:1163-1170. Go to original source... Go to PubMed...
  35. Steinberg JS, Shabanov V, Ponomarev D, et al. Effect of Renal Denervation and Catheter Ablation vs Catheter Ablation Alone on Atrial Fibrillation Recurrence Among Patients With Paroxysmal Atrial Fibrillation and Hypertension. Jama. 2020;323:248-255. Go to original source... Go to PubMed...
  36. Stevenson WG, Wilber DJ, Natale A, et al. Irrigated Radiofrequency Catheter Ablation Guided by Electroanatomic Mapping for Recurrent Ventricular Tachycardia After Myocardial Infarction. Circulation. 2008;118:2773-2782. Go to original source... Go to PubMed...
  37. MacIntyre CJ, Sapp JL, Abdelwahab A, et al. The Effect of Shock Burden on Heart Failure and Mortality. Cjc Open. 2019;1:161-167. Go to original source... Go to PubMed...
  38. Kamphuis HCM, Leeuw JRJd, Derksen R, et al. Implantable cardioverter defibrillator recipients: quality of life in recipients with and without ICD shock deliveryA prospective study. Ep Europace. 2003;5:381-389. Go to original source... Go to PubMed...
  39. Sahoo RK, Kar R, Dev I, et al. Stellate ganglion block as rescue therapy in drug­‑resistant electrical storm. Ann Cardiac Anaesth. 2021;24:415-418. Go to original source... Go to PubMed...
  40. Ukena C, Bauer A, Mahfoud F, et al. Renal sympathetic denervation for treatment of electrical storm: first­‑in­‑man experience. Clin Res Cardiol. 2012;101:63-67. Go to original source... Go to PubMed...
  41. Hoffmann BA, Steven D, Willems S, et al. Renal Sympathetic Denervation as an Adjunct to Catheter Ablation for the Treatment of Ventricular Electrical Storm in the Setting of Acute Myocardial Infarction. J Cardiovasc Electr. 2013;24:E21-E21. Go to original source... Go to PubMed...
  42. Hawson J, Harmer JA, Cowan M, et al. Renal Denervation for the Management of Refractory Ventricular Arrhythmias A Systematic Review. Jacc Clin Electrophysiol. 2021;7:100-108. Go to original source... Go to PubMed...
  43. Shantha GPS, Pancholy SB. Effect of renal sympathetic denervation on apnea­‑hypopnea index in patients with obstructive sleep apnea: a systematic review and meta­‑analysis. Sleep Breath. 2015;19:29-34. Go to original source... Go to PubMed...
  44. Warchol­‑Celinska E, Prejbisz A, Kadziela J, et al. Renal Denervation in Resistant Hypertension and Obstructive Sleep Apnea. Hypertension. 2018;72:381-390. Go to original source... Go to PubMed...
  45. Jonas DE, Amick HR, Feltner C, et al. Screening for Obstructive Sleep Apnea in Adults: Evidence Report and Systematic Review for the US Preventive Services Task Force. Jama. 2017;317:415-433. Go to original source... Go to PubMed...
  46. Bos DdSG, Happé C, Schalij I, et al. Renal Denervation Reduces Pulmonary Vascular Remodeling and Right Ventricular Diastolic Stiffness in Experimental Pulmonary Hypertension. Jacc Basic Transl Sci. 2017;2:22-35. Go to original source... Go to PubMed...
  47. Xue B, Yin H, Guo F, et al. Maternal Gestational Hypertension­‑Induced Sensitization of Angiotensin II Hypertension Is Reversed by Renal Denervation or Angiotensin­‑Converting Enzyme Inhibition in Rat Offspring. Hypertension. 2017;69:669-677. Go to original source... Go to PubMed...
  48. Lenski D, Kindermann I, Lenski M, et al. Anxiety, depression, quality of life and stress in patients with resistant hypertension before and after catheter­‑based renal sympathetic denervation. Eurointervention. 2013;9:700-708. Go to original source... Go to PubMed...
  49. Mahfoud F, Schlaich M, Kindermann I, et al. Effect of Renal Sympathetic Denervation on Glucose Metabolism in Patients With Resistant Hypertension. Circulation. 2011;123:1940-1946. Go to original source... Go to PubMed...
  50. Verloop WL, Spiering W, Vink EE, et al. Denervation of the Renal Arteries in Metabolic Syndrome. Hypertension. 2018;65:751-757. Go to original source... Go to PubMed...




Interventional Cardiology

Madam, Sir,
please be aware that the website on which you intend to enter, not the general public because it contains technical information about medicines, including advertisements relating to medicinal products. This information and communication professionals are solely under §2 of the Act n.40/1995 Coll. Is active persons authorized to prescribe or supply (hereinafter expert).
Take note that if you are not an expert, you run the risk of danger to their health or the health of other persons, if you the obtained information improperly understood or interpreted, and especially advertising which may be part of this site, or whether you used it for self-diagnosis or medical treatment, whether in relation to each other in person or in relation to others.

I declare:

  1. that I have met the above instruction
  2. I'm an expert within the meaning of the Act n.40/1995 Coll. the regulation of advertising, as amended, and I am aware of the risks that would be a person other than the expert input to these sites exhibited


No

Yes

If your statement is not true, please be aware
that brings the risk of danger to their health or the health of others.