title: Impact of renal sympathetic denervation on cardiac sympathetic nerve activity evaluated by cardiac MIBG imaging.
abstract: OBJECTIVE
  The objective of the present study was to investigate an effect of renal artery sympathetic denervation (RASD) on patients with resistant hypertension and RASD effect on cardiac sympathetic nerve activity. It is known that an abnormally activated sympathetic tone is associated with progression of heart failure (HF).
  
  
  RESULTS
  We investigated 16 patients with resistant arterial hypertension (mean age 54.88±7.89 years, mean 24-hr ambulatory blood pressure [BP] systolic 161.07±20.12 mmHg, diastolic 97.6±16.25 mmHg, using 6.44±0.96 antihypertensive drugs), who underwent bilateral RASD. Echocardiography, 24-hr ambulatory BP and 123I-metaiodobenzylguanidine (123I-MIBG) scintigraphy were performed before and six months after RASD. There were no significant changes in 24-hr ambulatory systolic and diastolic BP before RASD and six months after it: systolic BP before RASD was 161.07±20.12 mmHg and 144.93±17.27 mmHg after (p=0.050); diastolic BP before RASD was 97.6±16.25 mmHg and 89.87±12.33 mmHg after (p=0.182). We observed a significant change in cardiac sympathetic nerve activity assessed by 123I-MIBG scintigraphy, as an increase of late heart-to-mediastinum (H/M) ratio, varying from 2.21±0.47 to 2.35±0.52 m/s (p=0.02).
  
  
  CONCLUSIONS
  Selective RASD significantly reduces cardiac sympathetic overdrive assessed by 123I-MIBG scintigraphy. Presumably, this positively affects HF progression in patients with resistant arterial hypertension.
authors.affiliation: Center of Cardiology and Angiology, Vilnius University, Vilnius, Lithuania.
authors.forename: Andrius
authors.initials: A
authors.lastname: Berukstis
authors.forename: Donatas
authors.initials: D
authors.lastname: Vajauskas
authors.forename: Urte
authors.initials: U
authors.lastname: Gargalskaite
authors.forename: Nerijus
authors.initials: N
authors.lastname: Misonis
authors.forename: Greta
authors.initials: G
authors.lastname: Burneikaite
authors.forename: Diana
authors.initials: D
authors.lastname: Zakarkaite
authors.forename: Marius
authors.initials: M
authors.lastname: Miglinas
authors.forename: Aleksandras
authors.initials: A
authors.lastname: Laucevicius
mesh_terms: D019797:3-Iodobenzylguanidine; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects; D018660:Blood Pressure Monitoring, Ambulatory; D018450:Disease Progression; D004351:Drug Resistance; D004452:Echocardiography; D005260:Female; D006321:Heart / Q000294:innervation*; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D019275:Radiopharmaceuticals; D012077:Renal Artery / Q000294:innervation*; D012307:Risk Factors; D013562:Sympathectomy / Q000009:adverse effects; D013564:Sympathetic Nervous System / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome
chemical_list: D000959:Antihypertensive Agents; D019275:Radiopharmaceuticals; D019797:3-Iodobenzylguanidine