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Cardiovascular Journal of Africa 2019
Topics: Denervation; Kidney
PubMed: 31746940
DOI: 10.5830/CVJA-2019-056 -
Journal of the American College of... Jun 2021
Topics: Denervation; Humans; Hypertension; Kidney
PubMed: 33957238
DOI: 10.1016/j.jacc.2021.04.048 -
Chinese Medical Journal Dec 2022Given the unsatisfactory hypertension control rates and high rates of non-adherence to antihypertensive medications worldwide, device therapy which can safely provide...
Given the unsatisfactory hypertension control rates and high rates of non-adherence to antihypertensive medications worldwide, device therapy which can safely provide durable blood pressure-lowering effects can fulfill the unmet need. A series of second-generation randomized sham-controlled renal denervation (RDN) trials have demonstrated the efficacy and safety of RDN in a wide range of hypertensive patients. The four representative consensus documents on RDN (from the Chinese Taiwan Hypertension Society and Taiwan Society of Cardiology [THS/TSOC 2019], Asia Renal Denervation Consortium 2019, European Society of Hypertension [ESH 2021], and Society for Cardiovascular Angiography & Intervention and National Kidney Foundation [SCAI/NKF 2021]) consistently recommend RDN as an alternative or complementary treatment strategy for patients with uncontrolled hypertension. In addition, both documents from Asia further recommend that RDN can be considered as an initial treatment strategy for drug-naïve hypertensive patients. There is still inconsistency regarding whether ambulatory blood pressure monitoring should be used routinely both before and after RDN, and whether patients with a secondary cause of hypertension could be treated with RDN if their blood pressure remains uncontrolled after definitive treatment (treatment-resistant secondary hypertension). The THS/TSOC consensus provides acronyms to summarize key aspects of patient selection (RDNi2) and pre-RDN assessments (RAS). The ESH and SCAI/NKF documents recommend establishing structured pathways for clinical practice and issues regarding reimbursement. All documents identify knowledge gaps in RDN, from identifying predictors of super-responders to demonstrating effects on cardiovascular events. These gaps should be urgently filled to facilitate the wider application of this device therapy for patients with hypertension.
Topics: Humans; Blood Pressure Monitoring, Ambulatory; Consensus; Kidney; Hypertension; Blood Pressure; Antihypertensive Agents; Sympathectomy; Denervation; Treatment Outcome
PubMed: 36103983
DOI: 10.1097/CM9.0000000000002109 -
Journal of the American College of... Jun 2014
Topics: Denervation; Female; Heart; Humans; Male; Renal Artery
PubMed: 24632268
DOI: 10.1016/j.jacc.2013.12.048 -
ENeuro 2022Parkinson's disease (PD) results from a loss of dopaminergic neurons. What triggers the break-down of neuronal signaling, and how this might be compensated, is not...
Parkinson's disease (PD) results from a loss of dopaminergic neurons. What triggers the break-down of neuronal signaling, and how this might be compensated, is not understood. The age of onset, progression and symptoms vary between patients, and our understanding of the clinical variability remains incomplete. In this study, we investigate this, by characterizing the dopaminergic landscape in healthy and denervated striatum, using biophysical modeling. Based on currently proposed mechanisms, we model three distinct denervation patterns, and show how this affect the dopaminergic network. Depending on the denervation pattern, we show how local and global differences arise in the activity of striatal neurons. Finally, we use the mathematical formalism to suggest a cellular strategy for maintaining normal dopamine (DA) signaling following neuronal denervation. This strategy is characterized by dual enhancement of both the release and uptake capacity of DA in the remaining neurons. Overall, our results derive a new conceptual framework for the impaired dopaminergic signaling related to PD and offers testable predictions for future research directions.
Topics: Corpus Striatum; Denervation; Dopamine; Dopaminergic Neurons; Humans; Parkinson Disease
PubMed: 35165198
DOI: 10.1523/ENEURO.0458-21.2022 -
Physiological Reports Mar 2021The objective of this study was to assess the safety of surgical common hepatic artery denervation (CHADN). This procedure has previously been shown to improve glucose...
The objective of this study was to assess the safety of surgical common hepatic artery denervation (CHADN). This procedure has previously been shown to improve glucose tolerance in dogs fed a high-fat high-fructose (HFHF) diet. We assessed the hypoglycemic response of dogs by infusing insulin at a constant rate (1.5 mU/kg/min) for 3 h and monitoring glucose and the counterregulatory hormones (glucagon, catecholamine, and cortisol). After an initial hypoglycemic study, the dogs were randomly assigned to a SHAM surgery (n = 4) or hepatic sympathetic denervation (CHADN, n = 5) and three follow-up studies were performed every month up to 3 months after the surgery. The level of norepinephrine (NE) in the liver and the pancreas was significantly reduced in the CHADN dogs, showing a decrease in sympathetic tone to the splanchnic organs. There was no evidence of any defect of the response to hypoglycemia after the CHADN surgery. Indeed, the extent of hypoglycemia was similar in the SHAM and CHADN groups (~45 mg/dl) for the same amount of circulating insulin (~50 µU/ml) regardless of time or surgery. Moreover the responses of the counterregulatory hormones were similar in extent and pattern during the 3 h of hypoglycemic challenge. Circulating lactate, glycerol, free fatty acids, and beta-hydroxybutyrate were also unaffected by CHADN during fasting conditions or during the hypoglycemia. There were no other notable surgery-induced changes over time in nutrients, minerals, and hormones clinically measured in the dogs nor in the blood pressure and heart rate of the animals. The data suggest that the ablation of the sympathetic nerve connected to the splanchnic bed is not required for a normal counterregulatory response to insulin-induced hypoglycemia and that CHADN could be a safe new therapeutic intervention to improve glycemic control in individuals with metabolic syndrome or type 2 diabetes.
Topics: Animals; Denervation; Disease Models, Animal; Dogs; Glucose Clamp Technique; Glucose Intolerance; Hepatic Artery; Hyperglycemia; Insulin Resistance; Male
PubMed: 33769710
DOI: 10.14814/phy2.14805 -
American Journal of Physiology.... Jun 2021
Topics: Denervation; Urinary Bladder
PubMed: 33789439
DOI: 10.1152/ajpregu.00093.2021 -
JACC. Cardiovascular Interventions Dec 2015
Topics: Catheter Ablation; Denervation; Humans; Hypertension; Hypertension, Pulmonary; Kidney; Pulmonary Artery; Renal Artery; Sympathectomy; Sympathetic Nervous System
PubMed: 26738674
DOI: 10.1016/j.jcin.2015.10.022 -
American Journal of Nephrology 2024
Topics: Humans; Kidney; Sympathectomy; Hypertension; Animals
PubMed: 37651991
DOI: 10.1159/000533885 -
EuroIntervention : Journal of EuroPCR... May 2020
Topics: Catheter Ablation; Denervation; Hypertension; Kidney
PubMed: 32439627
DOI: 10.4244/EIJV16I1A4