Effective treatment of uncontrolled hypertension using catheter-based percutaneous renal denervation may depend strongly on the anatomic strategy applied when delivering therapy. We hypothesized that concentering in distal region artery would improve clinical response.We conducted a single-center, double-blind, randomized, controlled, and parallel group study (ClinicalTrials.gov NCT02667912). Fifty-one treatment-resistant hypertensive patients meeting guideline indications were randomized...

Objective: Actual procedure of renal denervation (RD) in Symplicity HTN-3 study - 4–6 point ablations equally distributed along the length and circumference main trunk artery (RA) may only be effective if nerves are likewise around RA strictly following its course. However, a number surgical studies demonstrated that form fan-shaped triangle plexus converging toward hilum, i.e. proximally go at distance from obliquely to course join it middle/distal portion so fibers available for...

Aim. To define and develop a procedure that can select patients with resistant hypertension (RH) for renal sympathetic denervation (RSD) procedure, by being orienting to the specific initial values of β-adrenoreactivity (β-AR) systolic blood pressure (SBP). Subjects methods. The analysis included 23 RH receiving maximally tolerable doses 4 antihypertensive drugs. investigations involving BP control Russian spectrophotometric determining β-AR in terms change osmoresistance erythrocyte...

The aim of the study was to evaluatetheglycemic control dynamics depending on degree blood pressure (BP) reduction and dynamic TNF-α after 6 12 months Tran catheter renal denervation (TRD) patients with true resistant hypertension (RH) type 2 diabetes mellitus (T2DM). Material methods. Thirty two essentially hypertensive (T2DM) were included in single-arm prospective interventional study. Office BP measurement, ambulatory 24-h BP, Doppler ultrasound assessment function (proteinuria,...

Objective. To study the changes of 24-hour blood pressure parameters and brain structure at follow-up after transcatheter renal denervation in resistant hypertension. Design methods. We enrolled patients with verified hypertension undergoing an intervention that included 4–8 applications radiofrequency discharge both arteries using a standard catheter5 F under controlled temperature regimen (60 С0, 8 Watt, 2-minute application). The efficiency was assessed by office decrease within 6 months...

Objective. To evaluate blood pressure (BP) lowering and dynamics of fasting glucose after transcatheter renal denervation (TRD) in patients with true resistant hypertension type 2 diabetes mellitus (T2DM). Design methods. Twenty five essential T2DM systolic BP (SBP) > 150 mmHg were included. Office measurement, 24-h ambulatory monitoring, Doppler ultrasound assessment function (creatinine, estimated glomerular filtration rate) performed at baseline 6 months TRD. None the changed antidiabetic...

Objective: We wished to assess the relationship between plasma concentrations of matrix metalloproteinases (MMP) and their tissue inhibitors with intrarenal vascular resistance level, renal function development microalbuminuria in patients resistant hypertension (RH) type 2 diabetes mellitus (DM). Design Method: A total 18 RH DM were included study (mean aged 58.6 ± 7.5 years, 6 male, office blood pressure (BP) 174.4 20.2/94.1 15.2 mmHg, basal glycaemia 8.8 2.3 mmol/L, HbA1c 6.8 0.7%, an...

Objective: The objectives of the study were to evaluate effects renal sympathetic denervation (RSD) on structural-functional characteristics heart and identify predictors efficacy this procedure in patients with resistant arterial hypertension. Design method: comprised 60 RSD (54.6 ± 9.5 years) who received full-dose antihypertensive therapy (4.1 drugs) including diuretics signed informed consent enroll study. examinations for evaluation parameters echocardiography performed before 24 weeks...

Studies were conducted in 58 patients (33 males and 25 females) aged 36 to 59 years who had arterial hypertension. 24-hour blood pressure (BP) monitoring brain magnetic resonance imaging performed all the before 5 after studies. Focal cerebral white matter lesions (FCWML) that been absent was found appear 15 (25%) patients; FCWML showed no changes 12 (21%) patients. There an increase number of 17 (30%). The whom appeared significantly higher baseline values BP its time indices and, on...

Design and methods. The office ambulatory blood pressure (BP) were assessed at baseline, 1 week, 6 12 months after RD in patients with resistant essential hypertension who underwent bilateral transcatheter radiofrequency single-arm prospective clinical study (ClinicalTrial.gov, NCT01499810). Results. Fifty three included (aged 53,8 ± 9,6 years, 28 males), 46 (87 %) 39 (74 completed follow-up, respectively. Office BP baseline was significantly higher than mean 24-h BP: 176,3/102,4 vs...

Purpose of the study was to elucidate effects treatment with calcium antagonists and beta-blockers on dynamics circadian blood pressure profile changes severity hypertensive encephalopathy according magnetic resonance imaging (mRI) dynamic x-ray computed tomography brain (DRKT). The involved 100 patients essential hypertension stage II, average age 51.0+9.5 years. Forty seven received Metoprolol (egilok retard, Egis, Hungary) at a dose 25-100 mg; 29 felodipine (felodip, IVAX, Czech Republic)...

Objective: Rate dynamics of daily monitoring blood pressure in patients with resistant hypertension. Design and method: The study included 53 (mean age 54,6 ± 19,6 years) drug-resistant essential All underwent ambulatory (BP) at baseline, after 12 months renal denervation (RD). Results: original figures average BP amounted to 155,6/93,5 mmHg. After according the showed marked antihypertensive effect reduction on a 13.0/−7,9 Revealed similar decline (−15,8/−9,0 mmHg.) night (−12,0/−8,7) level...

Objective: To evaluate long-term effect of catheter-based renal denervation (RDN) on glucose metabolism and blood pressure control in patients with resistant hypertension diabetes mellitus type 2. Design method: Thirty two true 2 were included single-arm prospective interventional study (detailed protocol was published ClinicalTrial.gov, number NCT01499810). Office (BP) measurement, ambulatory 24-h BP, HbA1c, basal postprandial plasma levels glucose, insulin C-peptide calculation Homeostasis...

Objective: Chronic activation of the sympathetic nervous system (SNS) is causative in pathophysiology hypertension. Besides this, SNS activates immune system. Inflammation, and hypertension may interact treatment one two conditions could have some impact on other. Renal denervation (RDN) a promising for Beforehand, we hypothesized that reduction following RDN lead to decreased inflammatory cytokines. The aim this study was evaluate dynamics TNF-α interleukin-1 β after catheter-based patients...

Objective: Investigate the possible predictors of stroke, according to a five-year follow-up in hypertensive patients. Design and method: Eighty essential patients aged between 30–59 years were observed within 5 years. General clinical investigation, 24-h ABPM brain MRI performed all at onset study after observation. Presence increased subarachnoidal spaces (SS) lateral ventricles (LV) brain, periventricular leucoaraiosis (PL), lacuna infarcts (LI) focal white matter lesions (FWML) evaluated...

Objective: The aim of the study was to changes hypercapnic brain arterial reactivity (BAR) and frequency occurrence in investigation patients with hypertension. Design method: All participants research have given informed agreement. We used ultasonography transcranial Doppler‘s method middle cerebral arteries (MCA) from temporal window. studied flow Velocity mean (Vm) starting, during hypercapnia (HC - inhalation 2 min 4% mixture carbonic gas (MCG) air FmV period recovery (rec)...

Objective: The aim of the study was to changes hyperoxic brain arterial reactivity (BAR) and frequency occurrence in investigation patients with hypertension. Design method: All participants research have given informed agreement. We used ultasonography transcranial Doppler‘s method middle cerebral arteries (MCA) from temporal window. studied flow Velocity mean (Vm) starting, during hyperoxia (inhalation 2 min 100% oxygen) FmV period recovery (rec) (air-inhalation min) 264 essentially...

Objective: To evaluate the long-term effect of transcatheter renal denervation (TRD) on presence and severity pathological structural changes a brain in resistant hypertensive patients (ClinicalTrials.gov number NCT01499810). Design method: Twenty three aged between 30–70 years were included study. TRD was performed as bilateral endovascular radiofrequency ablation neural pathways adjacent to artery. Detailed clinical investigation, 24-h ABPM MRI all at baseline 12 months after TRD....

Objective: To investigate the effect of catheter-based renal denervation (RDN) on left ventricular mass index (LVMI) in relation with blood pressure (BP) reduction patients resistant hypertension and diabetes mellitus. Design method: Thirty two true type 2 mellitus were included single-arm prospective interventional study (detailed protocol was published ClinicalTrial.gov, number NCT01499810). Office BP measurement, ambulatory 24-h BP, transthoracic echocardiography assessment LVMI performed...

Objective: Surgical and recently anatomical studies demonstrated a fan-like form of renal plexus converging toward gate. Therefore, number fibers adjacent to the artery available for endovascular ablation is rather small in proximal portion but grows maximum its distal part. To evaluate whether denervation treatment part more effective than conventional mode intervention. Design method: We developed RDN targeting segmental branches compared it single-blind 1:1 randomized controlled parallel...

Objective: The aim of the study was to classify changes brain arterial reactivity (BAR) during hypercapnia and hyperoxia in patients with hypertension. Design method: All participants research have given informed agreement. We used ultasonography transcranial Doppler‘s method middle cerebral arteries (MCA) from temporal window. studied flow Velocity mean (Vm) starting, (inhalation 2 min 4% mixture carbonic gas (MCG) air or - 100% oxygen FmV period recovery (rec) (air-inhalation min) 278...

Objective: A failure of endovascular renal denervation (RDN) as a series point treatments equally distributed within main trunk artery (Symplicity and other methods) was easily predictable. It may only be effective if all nerves closely follow the course (RA) from aorta to kidney. However, surgical studies demonstrated that proximally most go at distance RA join mainly its distal part. To evaluate whether treatment in part is more than conventional RDN. Design Method: We developed mode RDN...