Predicting Renal Denervation Response in Resistant High Blood Pressure by Arterial Stiffness Assessment: A Systematic Review
Background: Accurately selecting hypertensive candidates for renal denervation (RDN) therapy is required, as one-third of patients who undergo RDN are non-responders. We aimed to systematically review the literature on RDN response prediction using arterial stiffness assessment, optimizing the selec...
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-08-01
|
| Series: | Journal of Clinical Medicine |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2077-0383/11/16/4837 |
| _version_ | 1797444357451677696 |
|---|---|
| author | Alexandru Burlacu Crischentian Brinza Mariana Floria Anca Elena Stefan Andreea Covic Adrian Covic |
| author_facet | Alexandru Burlacu Crischentian Brinza Mariana Floria Anca Elena Stefan Andreea Covic Adrian Covic |
| author_sort | Alexandru Burlacu |
| collection | DOAJ |
| description | Background: Accurately selecting hypertensive candidates for renal denervation (RDN) therapy is required, as one-third of patients who undergo RDN are non-responders. We aimed to systematically review the literature on RDN response prediction using arterial stiffness assessment, optimizing the selection of patients referred for interventional blood pressure lowering procedures. Methods: A literature search was performed in MEDLINE, Embase, Scopus, and Cochrane databases to retrieve potential eligible studies from the inception to 30 June 2022. Results: Ten studies were finally included in this systematic review. Studies consistently documented that invasive pulse wave velocity (PWV) was correlated with RDN’s significant success. Nevertheless, non-invasive ambulatory arterial stiffness index and PWV derived from ambulatory blood pressure monitoring were independent predictors of blood pressure response (<i>p</i> = 0.04 and <i>p</i> < 0.0001). In some studies, magnetic resonance imaging parameters of arterial stiffness (ascending aortic distensibility, total arterial compliance) were correlated with blood pressure reduction (AUC = 0.828, <i>p</i> = 0.006). Conclusions: Assessing arterial stiffness prior to RDN predicted procedural success, since stiffness parameters were strongly correlated with a significant blood pressure response. Our endeavor should be tackled as a step forward in selecting appropriate hypertensive patients scheduled for RDN therapy. Non-invasive measurements could be an alternative to invasive parameters for response prediction. |
| first_indexed | 2024-03-09T13:11:30Z |
| format | Article |
| id | doaj.art-4f6d8e7e477444d0a32d11c45e8e0826 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T13:11:30Z |
| publishDate | 2022-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-4f6d8e7e477444d0a32d11c45e8e08262023-11-30T21:41:30ZengMDPI AGJournal of Clinical Medicine2077-03832022-08-011116483710.3390/jcm11164837Predicting Renal Denervation Response in Resistant High Blood Pressure by Arterial Stiffness Assessment: A Systematic ReviewAlexandru Burlacu0Crischentian Brinza1Mariana Floria2Anca Elena Stefan3Andreea Covic4Adrian Covic5Faculty of Medicine, University of Medicine and Pharmacy “Grigore T Popa”, 700115 Iasi, RomaniaFaculty of Medicine, University of Medicine and Pharmacy “Grigore T Popa”, 700115 Iasi, RomaniaFaculty of Medicine, University of Medicine and Pharmacy “Grigore T Popa”, 700115 Iasi, RomaniaFaculty of Medicine, University of Medicine and Pharmacy “Grigore T Popa”, 700115 Iasi, RomaniaFaculty of Medicine, University of Medicine and Pharmacy “Grigore T Popa”, 700115 Iasi, RomaniaFaculty of Medicine, University of Medicine and Pharmacy “Grigore T Popa”, 700115 Iasi, RomaniaBackground: Accurately selecting hypertensive candidates for renal denervation (RDN) therapy is required, as one-third of patients who undergo RDN are non-responders. We aimed to systematically review the literature on RDN response prediction using arterial stiffness assessment, optimizing the selection of patients referred for interventional blood pressure lowering procedures. Methods: A literature search was performed in MEDLINE, Embase, Scopus, and Cochrane databases to retrieve potential eligible studies from the inception to 30 June 2022. Results: Ten studies were finally included in this systematic review. Studies consistently documented that invasive pulse wave velocity (PWV) was correlated with RDN’s significant success. Nevertheless, non-invasive ambulatory arterial stiffness index and PWV derived from ambulatory blood pressure monitoring were independent predictors of blood pressure response (<i>p</i> = 0.04 and <i>p</i> < 0.0001). In some studies, magnetic resonance imaging parameters of arterial stiffness (ascending aortic distensibility, total arterial compliance) were correlated with blood pressure reduction (AUC = 0.828, <i>p</i> = 0.006). Conclusions: Assessing arterial stiffness prior to RDN predicted procedural success, since stiffness parameters were strongly correlated with a significant blood pressure response. Our endeavor should be tackled as a step forward in selecting appropriate hypertensive patients scheduled for RDN therapy. Non-invasive measurements could be an alternative to invasive parameters for response prediction.https://www.mdpi.com/2077-0383/11/16/4837resistant arterial hypertensionrenal denervationrespondersnon-respondersprediction |
| spellingShingle | Alexandru Burlacu Crischentian Brinza Mariana Floria Anca Elena Stefan Andreea Covic Adrian Covic Predicting Renal Denervation Response in Resistant High Blood Pressure by Arterial Stiffness Assessment: A Systematic Review Journal of Clinical Medicine resistant arterial hypertension renal denervation responders non-responders prediction |
| title | Predicting Renal Denervation Response in Resistant High Blood Pressure by Arterial Stiffness Assessment: A Systematic Review |
| title_full | Predicting Renal Denervation Response in Resistant High Blood Pressure by Arterial Stiffness Assessment: A Systematic Review |
| title_fullStr | Predicting Renal Denervation Response in Resistant High Blood Pressure by Arterial Stiffness Assessment: A Systematic Review |
| title_full_unstemmed | Predicting Renal Denervation Response in Resistant High Blood Pressure by Arterial Stiffness Assessment: A Systematic Review |
| title_short | Predicting Renal Denervation Response in Resistant High Blood Pressure by Arterial Stiffness Assessment: A Systematic Review |
| title_sort | predicting renal denervation response in resistant high blood pressure by arterial stiffness assessment a systematic review |
| topic | resistant arterial hypertension renal denervation responders non-responders prediction |
| url | https://www.mdpi.com/2077-0383/11/16/4837 |
| work_keys_str_mv | AT alexandruburlacu predictingrenaldenervationresponseinresistanthighbloodpressurebyarterialstiffnessassessmentasystematicreview AT crischentianbrinza predictingrenaldenervationresponseinresistanthighbloodpressurebyarterialstiffnessassessmentasystematicreview AT marianafloria predictingrenaldenervationresponseinresistanthighbloodpressurebyarterialstiffnessassessmentasystematicreview AT ancaelenastefan predictingrenaldenervationresponseinresistanthighbloodpressurebyarterialstiffnessassessmentasystematicreview AT andreeacovic predictingrenaldenervationresponseinresistanthighbloodpressurebyarterialstiffnessassessmentasystematicreview AT adriancovic predictingrenaldenervationresponseinresistanthighbloodpressurebyarterialstiffnessassessmentasystematicreview |