title: Biomarker response and therapy prediction in renal denervation therapy - the role of MR-proadrenomedullin in a multicenter approach.
abstract: BACKGROUND
  Renal denervation has been proposed as a therapeutic option in patients with resistant hypertension. Circulating blood borne biomarkers might be helpful to identify individuals responding to RDN therapy. MR-proADM is a strong prognostic marker in patients with cardiovascular disease. The aim of this multicenter study was to evaluate the effect of RDN on MR-proADM concentrations.
  
  
  RESULTS
  We measured MR-proADM, BNP, and MR-proANP in 110 patients before and after RDN in a multicenter setting. All patients were followed up after 1 and 6 months by office and ambulatory blood pressure (BP) measurements. The mean office BP decreased from 165/89 to 152/87 mmHg 6 months after RDN (systolic: p < 0.001; diastolic: ns), the responder-rate was 74%. Intriguingly MR-proADM concentrations increased from 0.66 to 0.69 nmol/L (p < 0.001) and were significantly associated with reduction of systolic office BP after 6 months in multivariate analyses (coefficient -0.0018, p < 0.001). In therapy-responders MR-proADM concentrations showed a significantly higher increase over time (coefficient 0.0105, p < 0.05), as compared to non-responders. There were no significant differences in BP change for individuals with low and high baseline MR-proADM (BP-Delta low MR-proADM -23/-4 mmHg vs. high MR-proADM -24/-5 mmHg). The natriuretic biomarkers BNP and MR-proANP did not change significantly after 6 months. Biomarkers at baseline were not able to predict for therapy-responder.
  
  
  CONCLUSIONS
  In patients undergoing RDN, baseline measurements of various biomarkers had no prognostic use for therapy success in this short time follow-up period in a multicenter approach. Intriguingly, MR-proADM showed a significant association with BP reduction after 6 months.
authors.affiliation: a Department of General and Interventional Cardiology , Hamburg University Heart Center , Hamburg , Germany.
authors.forename: Johannes Tobias
authors.initials: JT
authors.lastname: Neumann
authors.affiliation: b Department of Cardiology and Division of Emergency Medicine, Campus Virchow Klinikum and Campus Charité Mitte , Charité Universitätsmedizin Berlin , Germany.
authors.forename: Marius
authors.initials: M
authors.lastname: Schwerg
authors.affiliation: c Department of Internal Medicine I, Cardiology/Angiology , Giessen University , Giessen , Germany.
authors.forename: Oliver
authors.initials: O
authors.lastname: Dörr
authors.affiliation: d Department of Medical Clinic II, Cardiology , University of Lübeck , Lübeck , Germany.
authors.forename: Kai
authors.initials: K
authors.lastname: Mortensen
authors.affiliation: d Department of Medical Clinic II, Cardiology , University of Lübeck , Lübeck , Germany.
authors.forename: Klaas
authors.initials: K
authors.lastname: Franzen
authors.affiliation: a Department of General and Interventional Cardiology , Hamburg University Heart Center , Hamburg , Germany.
authors.forename: Tanja
authors.initials: T
authors.lastname: Zeller
authors.affiliation: a Department of General and Interventional Cardiology , Hamburg University Heart Center , Hamburg , Germany.
authors.forename: Francisco
authors.initials: F
authors.lastname: Ojeda
authors.affiliation: a Department of General and Interventional Cardiology , Hamburg University Heart Center , Hamburg , Germany.
authors.forename: Stefan
authors.initials: S
authors.lastname: Blankenberg
authors.affiliation: c Department of Internal Medicine I, Cardiology/Angiology , Giessen University , Giessen , Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Hamm
authors.affiliation: c Department of Internal Medicine I, Cardiology/Angiology , Giessen University , Giessen , Germany.
authors.forename: Holger
authors.initials: H
authors.lastname: Nef
authors.affiliation: b Department of Cardiology and Division of Emergency Medicine, Campus Virchow Klinikum and Campus Charité Mitte , Charité Universitätsmedizin Berlin , Germany.
authors.forename: Verena
authors.initials: V
authors.lastname: Stangl
authors.affiliation: b Department of Cardiology and Division of Emergency Medicine, Campus Virchow Klinikum and Campus Charité Mitte , Charité Universitätsmedizin Berlin , Germany.
authors.forename: Martin
authors.initials: M
authors.lastname: Möckel
authors.affiliation: a Department of General and Interventional Cardiology , Hamburg University Heart Center , Hamburg , Germany.
authors.forename: Karsten
authors.initials: K
authors.lastname: Sydow
mesh_terms: D053607:Adrenomedullin / Q000502:physiology*; D000368:Aged; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D003714:Denervation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000628:therapy*; D007668:Kidney / Q000294:innervation*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood; D011379:Prognosis; D011498:Protein Precursors / Q000502:physiology*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D011498:Protein Precursors; C088633:proadrenomedullin; D020097:Natriuretic Peptide, Brain; D053607:Adrenomedullin
keywords: ADM; adrenomedullin; biomarkers; hypertension; renal denervation; responder