title: Influence of Renal Sympathetic Denervation on Cardiac Extracellular Matrix Turnover and Cardiac Fibrosis.
abstract: BACKGROUND
  Renal sympathetic denervation (RSD) represents an effective treatment option for patients with resistant arterial hypertension (HT). Extracellular matrix (ECM) turnover and deposition are essential processes in HT-related cardiovascular remodeling, fibrosis, and cardiac hypertrophy and contribute to hypertensive heart disease.
  
  
  OBJECTIVE
  The primary aim of the present study was to examine the effect of RSD on increased collagen turnover as reflected by serum levels of amino-terminal pro-peptides (PINP, PIIINP) and a carboxyl-terminal pro-peptide (PICP), specific biomarkers for cardiac ECM turnover and cardiovascular fibrosis.
  
  
  METHODS
  A total of 100 consecutive patients (mean age: 65.9±10.1 years) undergoing RSD were included in this study. A therapeutic response was defined as an office systolic blood pressure (SBP) reduction of >10mm Hg 6 months after RSD. Venous serum samples for measurement of PICP, PINP, and PIIINP were collected prior to and 6 months after RSD.
  
  
  RESULTS
  A significant reduction in the office SBP of 24.3 mm Hg (SBP baseline: 166.9±14.3 mm Hg (P < 0.001) was documented 6 months after RSD. At this time point, the serum levels of PICP, PINP, and PIIINP (P < 0.01) were significantly decreased compared to baseline values in patients with an increased collagen turnover, showing significant differences comparing BP responders and nonresponders.
  
  
  CONCLUSIONS
  In addition to the effective blood pressure reduction in response to RSD, this study demonstrates a positive effect of RSD on biomarkers reflecting cardiovascular ECM turnover and deposition. These results suggest a beneficial effect of RSD on cardiovascular fibrosis, hypertensive heart disease, and end-organ damage in high-risk patients.
authors.affiliation: Department of Cardiology, University of Giessen, Giessen, Germany; oliver.doerr@innere.med.uni-giessen.de.
authors.forename: Oliver
authors.initials: O
authors.lastname: Dörr
authors.affiliation: Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Liebetrau
authors.affiliation: Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany.
authors.forename: Helge
authors.initials: H
authors.lastname: Möllmann
authors.affiliation: Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany.
authors.forename: Luise
authors.initials: L
authors.lastname: Gaede
authors.affiliation: Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Troidl
authors.affiliation: Department of Cardiology, University of Giessen, Giessen, Germany;
authors.forename: Kareen
authors.initials: K
authors.lastname: Morczeck
authors.affiliation: Department of Cardiology, University of Giessen, Giessen, Germany;
authors.forename: Jens
authors.initials: J
authors.lastname: Wiebe
authors.affiliation: Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany.
authors.forename: Jedrzej
authors.initials: J
authors.lastname: Hoffmann
authors.affiliation: Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany.
authors.forename: Sandra
authors.initials: S
authors.lastname: Voss
authors.affiliation: Department of Cardiology, University of Giessen, Giessen, Germany;
authors.forename: Timm
authors.initials: T
authors.lastname: Bauer
authors.affiliation: Department of Cardiology, University of Giessen, Giessen, Germany; Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Hamm
authors.affiliation: Department of Cardiology, University of Giessen, Giessen, Germany;
authors.forename: Holger
authors.initials: H
authors.lastname: Nef
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D003094:Collagen / Q000378:metabolism*; D005109:Extracellular Matrix / Q000378:metabolism*; D005260:Female; D005355:Fibrosis / Q000517:prevention & control; D005500:Follow-Up Studies; D006331:Heart Diseases / Q000517:prevention & control*; D006801:Humans; D006973:Hypertension / Q000601:surgery; D007668:Kidney / Q000294:innervation*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D013562:Sympathectomy
chemical_list: D015415:Biomarkers; D003094:Collagen
keywords: blood pressure; essential hypertension; fibrosis; hypertension; renal denervation.