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Hypertension and Heart Failure pp 377–389Cite as

Renal Nerve Ablation

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Part of the book series: Updates in Hypertension and Cardiovascular Protection ((UHCP))

Abstract

A sympathetic overdrive is central to the development and clinical course of heart failure. As the kidneys are significant modulators of sympathetic activity, renal nerve ablation (RNA) stands as an intriguing therapeutic option to control the progression and prognosis of the disease. A number of studies have provided evidence of an effect of RNA on blood pressure as well as on heart size and function. Experimental studies in heart failure models have shown that RNA interferes with water and salt retention, the renin-angiotensin axis, and the sympathetic overflow to the heart. A series of small studies of RNA in humans with heart failure have provided promising data with respect to functional status, neurohormonal activation, and clinical and prognostic biomarkers. As pending trials will provide data on the true efficacy of transcatheter RNA, the solid pathophysiologic basis supports the need for larger trials in heart failure patients.

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Abbreviations

AT1R:

Angiotensin II type 1 receptor

AT2R:

Angiotensin II type 2 receptor

BP:

Blood pressure

HF:

Heart failure

HFpEF:

Heart failure with preserved ejection fraction

HFrEF:

Heart failure with reduced ejection fraction

LV:

Left ventricle

LVEF:

Left ventricular ejection fraction

MSNA:

Muscle sympathetic nerve activity

NT-pro-BNP:

N-terminal pro-B-type natriuretic peptide

NYHA:

New York Heart Association

OMT:

Optimal medical therapy

RNA:

Renal nerve ablation

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Author information

Authors and Affiliations

  1. First Cardiology Clinic, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece

    Konstantinos Tsioufis

  2. First Cardiology Clinic, Medical School, National and Kapodistrian University of Athens, Hippokration Hospital, Athens, Greece

    Panagiotis Iliakis & Alexandros Kasiakogias

Authors
  1. Konstantinos Tsioufis
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  2. Panagiotis Iliakis
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  3. Alexandros Kasiakogias
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Corresponding author

Correspondence to Konstantinos Tsioufis .

Editor information

Editors and Affiliations

  1. Carol Davila University of Medicine and Pharmacy Bucharest and Cardiology Department, Emergency Clinical Hospital, Bucharest, Romania

    Maria Dorobantu

  2. University of Milano-Bicocca, Milano, Italy

    Giuseppe Mancia  & Guido Grassi  & 

  3. Department of Pharmacology, Toxicology and Clinical Psychopharmacology Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania

    Victor Voicu

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Tsioufis, K., Iliakis, P., Kasiakogias, A. (2019). Renal Nerve Ablation. In: Dorobantu, M., Mancia, G., Grassi, G., Voicu, V. (eds) Hypertension and Heart Failure. Updates in Hypertension and Cardiovascular Protection. Springer, Cham. https://doi.org/10.1007/978-3-319-93320-7_24

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  • DOI: https://doi.org/10.1007/978-3-319-93320-7_24

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-93319-1

  • Online ISBN: 978-3-319-93320-7

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