title: Invasive aortic pulse wave velocity as a marker for arterial stiffness predicts outcome of renal sympathetic denervation.
abstract: OBJECTIVE
  A recurrent finding of trials on renal sympathetic denervation is a certain percentage of non-responders. The aim of this study was to examine the influence of arterial stiffness to predict response.
  
  
  RESULTS
  Eighty-eight patients were included in the study. Arterial stiffness was measured by invasive pulse wave velocity. Antihypertensive medication had to be unchanged during follow-up. Ambulatory blood pressure measurement (ABPM) was used to record blood pressure before and six months after denervation. Fifty-eight patients without changes in medication were included in the final analysis. Responders (n=37; blood pressure reduction -12.8±6.4 mmHg) had a significantly lower pulse wave velocity (14.4±4.4 m/s versus 17.7±4.5 m/s; p=0.009) compared to non-responders (n=21; blood pressure reduction +3.0±4.5 mmHg; p<0.001 for comparison with responders). In multivariate analysis, invasive pulse wave velocity was the only significant predictor of blood pressure reduction after denervation (odds ratio 1.15, 95% confidence interval [CI] 1.014-1.327; p=0.03). Patients with increased stiffness were older (p=0.001), had a higher prevalence of diabetes (p=0.008), more often had isolated systolic hypertension (p=0.007), and had a higher invasive pulse pressure (p<0.001).
  
  
  CONCLUSIONS
  Patients with lower pulse wave velocity showed a significantly better response to denervation. These findings emphasise that pulse wave velocity might be used as a selection criterion for renal denervation.
authors: Department of Internal Medicine/Cardiology, University of Leipzig, Heart Center, Leipzig, Germany.
authors: Thomas
authors: T
authors: Okon
authors: Karoline
authors: K
authors: Röhnert
authors: Thomas
authors: T
authors: Stiermaier
authors: Karl-Philipp
authors: KP
authors: Rommel
authors: Ulrike
authors: U
authors: Müller
authors: Karl
authors: K
authors: Fengler
authors: Gerhard
authors: G
authors: Schuler
authors: Steffen
authors: S
authors: Desch
authors: Philipp
authors: P
authors: Lurz
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology*; D001795:Blood Pressure Determination / Q000379:methods; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods; D003714:Denervation; D005260:Female; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000503:physiopathology*; D007668:Kidney / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D063177:Pulse Wave Analysis / Q000379:methods; D059289:Vascular Stiffness / Q000502:physiology*
chemical_list: D000959:Antihypertensive Agents