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Renal Nerve Ablation

  • Konstantinos TsioufisEmail author
  • Panagiotis Iliakis
  • Alexandros Kasiakogias
Chapter
Part of the Updates in Hypertension and Cardiovascular Protection book series (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.

Keywords

Sympathetic overactivity Heart failure Resistant hypertension Angiotensin Radiofrequency catheter 

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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Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Konstantinos Tsioufis
    • 1
    Email author
  • Panagiotis Iliakis
    • 2
  • Alexandros Kasiakogias
    • 2
  1. 1.First Cardiology ClinicNational and Kapodistrian University of Athens, Hippokration HospitalAthensGreece
  2. 2.First Cardiology ClinicMedical School, National and Kapodistrian University of Athens, Hippokration HospitalAthensGreece

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