Retinal microperfusion after renal denervation in treatment-resistant hypertensive patients

Ott, Christian; Harazny, Joanna; Schmid, Axel; Ditting, Tilmann; Veelken, Roland; Bladowski, Marek; Michelson, Georg; Uder, Michael; Schmieder, Roland E.

doi:10.1007/s00392-015-0845-0

Cited by 5 publications

(3 citation statements)

References 35 publications

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“…Thereby, an increased PP and augmented pulsatile flow induce greater sheer stress on the endothelium of small arteries, which on the long run leads to endothelial dysfunction and microvascular damage. 45 Harazny et al discovered a significantly exaggerated pulsed RCF (without any difference in mean RCF) in subjects with treatment-resistant hypertension compared with subjects with hypertension Stage 1 or 2 by means of SLDF, indicating vascular remodelling and microvascular damage in this group of subjects. 46 Vascular structure and function play a key role in the pathophysiology of CHF.…”

Section: Discussionmentioning

confidence: 95%

“…Thereby, an increased PP and augmented pulsatile flow induce greater sheer stress on the endothelium of small arteries, which on the long run leads to endothelial dysfunction and microvascular damage. 45 46 Vascular structure and function play a key role in the pathophysiology of CHF. 47 Endothelial dysfunction and remodelling of the peripheral vascular system, for example the brachial artery, have been previously shown to be associated with the pathogenesis and progression of CHF.…”

Section: Discussionmentioning

confidence: 99%

“…A widening of PP due to a mostly age‐related increase in systolic and decrease in diastolic BP is known to be indicative of loss of arterial elasticity. Thereby, an increased PP and augmented pulsatile flow induce greater sheer stress on the endothelium of small arteries, which on the long run leads to endothelial dysfunction and microvascular damage 45 . Harazny et al .…”

Section: Discussionmentioning

confidence: 99%

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Hypertrophic remodelling of retinal arterioles in patients with congestive heart failure

et al. 2021

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Aims Analysis of microvascular parameters in the retinal circulation-known to reflect those in the systemic circulation -allows us to differentiate between eutrophic and hypertrophic remodelling of small arteries. This study aimed to examine microvascular changes in patients with congestive heart failure (CHF) and reduced as well as mid-range ejection fraction. Methods and results Forty subjects with CHF underwent measurement of retinal capillary flow (RCF), wall-to-lumen ratio (WLR), vessel and lumen diameter, wall thickness, and wall cross-sectional area (WCSA) of retinal arterioles of the right eye by scanning laser Doppler flowmetry (SLDF). Applying a matched pair approach, we compared this group with reference values of age-matched controls from a random sample in the population of Pilsen, Czech Republic. There was no significant difference in RCF and WLR between the groups (RCF:

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Section: Discussionmentioning

confidence: 95%

“…Thereby, an increased PP and augmented pulsatile flow induce greater sheer stress on the endothelium of small arteries, which on the long run leads to endothelial dysfunction and microvascular damage. 45 46 Vascular structure and function play a key role in the pathophysiology of CHF. 47 Endothelial dysfunction and remodelling of the peripheral vascular system, for example the brachial artery, have been previously shown to be associated with the pathogenesis and progression of CHF.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Hypertrophic remodelling of retinal arterioles in patients with congestive heart failure

et al. 2021

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Renal artery sympathetic denervation: observations from the UK experience

et al. 2016

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BackgroundRenal denervation (RDN) may lower blood pressure (BP); however, it is unclear whether medication changes may be confounding results. Furthermore, limited data exist on pattern of ambulatory blood pressure (ABP) response—particularly in those prescribed aldosterone antagonists at the time of RDN.MethodsWe examined all patients treated with RDN for treatment-resistant hypertension in 18 UK centres.ResultsResults from 253 patients treated with five technologies are shown. Pre-procedural mean office BP (OBP) was 185/102 mmHg (SD 26/19; n = 253) and mean daytime ABP was 170/98 mmHg (SD 22/16; n = 186). Median number of antihypertensive drugs was 5.0: 96 % ACEi/ARB; 86 % thiazide/loop diuretic and 55 % aldosterone antagonist. OBP, available in 90 % at 11 months follow-up, was 163/93 mmHg (reduction of 22/9 mmHg). ABP, available in 70 % at 8.5 months follow-up, was 158/91 mmHg (fall of 12/7 mmHg). Mean drug changes post RDN were: 0.36 drugs added, 0.91 withdrawn. Dose changes appeared neutral. Quartile analysis by starting ABP showed mean reductions in systolic ABP after RDN of: 0.4; 6.5; 14.5 and 22.1 mmHg, respectively (p < 0.001 for trend). Use of aldosterone antagonist did not predict response (p > 0.2).ConclusionIn 253 patients treated with RDN, office BP fell by 22/9 mmHg. Ambulatory BP fell by 12/7 mmHg, though little response was seen in the lowermost quartile of starting blood pressure. Fall in BP was not explained by medication changes and aldosterone antagonist use did not affect response.Electronic supplementary materialThe online version of this article (doi:10.1007/s00392-015-0959-4) contains supplementary material, which is available to authorized users.

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