title: Cardiorespiratory response to exercise after renal sympathetic denervation in patients with resistant hypertension.
abstract: OBJECTIVE
  This study sought to investigate the effects of interventional renal sympathetic denervation (RD) on cardiorespiratory response to exercise.
  
  
  BACKGROUND
  RD reduces blood pressure at rest in patients with resistant hypertension.
  
  
  METHODS
  We enrolled 46 patients with therapy-resistant hypertension as extended investigation of the Symplicity HTN-2 (Renal Denervation With Uncontrolled Hypertension) trial. Thirty-seven patients underwent bilateral RD and 9 patients were assigned to the control group. Cardiopulmonary exercise tests were performed at baseline and 3-month follow-up.
  
  
  RESULTS
  In the RD group, compared with baseline examination, blood pressure at rest and at maximum exercise after 3 months was significantly reduced by 31 ± 13/9 ± 13 mm Hg (p < 0.0001) and by 21 ± 20/5 ± 14 mm Hg (p < 0.0001), respectively. Achieved work rate increased by 5 ± 13 W (p = 0.029) whereas peak oxygen uptake remained unchanged. Blood pressure 2 min after exercise was significantly reduced by 29 ± 17/8 ± 15 mm Hg (p < 0.001 for systolic blood pressure; p = 0.002 for diastolic blood pressure). Heart rate at rest decreased after RD (4 ± 11 beats/min; p = 0.028), whereas maximum heart rate and heart rate increase during exercise were not different. Heart rate recovery improved significantly by 4 ± 7 beats/min after renal denervation (p = 0.009). In the control group, there were no significant changes in blood pressure, heart rate, maximum work rate, or ventilatory parameters after 3 months.
  
  
  CONCLUSIONS
  RD reduces blood pressure during exercise without compromising chronotropic competence in patients with resistant hypertension. Heart rate at rest decreased and heart rate recovery improved after the procedure. (Renal Denervation With Uncontrolled Hypertension; [Symplicity HTN-2]; NCT00888433).
authors: Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany. Christian.Ukena@uks.eu
authors: Christian
authors: C
authors: Ukena
authors: Felix
authors: F
authors: Mahfoud
authors: Ingrid
authors: I
authors: Kindermann
authors: Christine
authors: C
authors: Barth
authors: Matthias
authors: M
authors: Lenski
authors: Michael
authors: M
authors: Kindermann
authors: Mathias C
authors: MC
authors: Brandt
authors: Uta C
authors: UC
authors: Hoppe
authors: Henry
authors: H
authors: Krum
authors: Murray
authors: M
authors: Esler
authors: Paul A
authors: PA
authors: Sobotka
authors: Michael
authors: M
authors: Böhm
mesh_terms: D000368:Aged; D001794:Blood Pressure; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005260:Female; D006339:Heart Rate; D006801:Humans; D006973:Hypertension / Q000601:surgery*; D007668:Kidney / Q000294:innervation*; D008297:Male; D008875:Middle Aged; D012119:Respiration; D013562:Sympathectomy