Predictors of blood pressure response to ultrasound renal denervation in the RADIANCE-HTN SOLO study
Manish Saxena
(1)
,
Roland Schmieder
(2)
,
Ajay Kirtane
(3)
,
Felix Mahfoud
(4, 5)
,
Joost Daemen
(6)
,
Jan Basile
(7)
,
Philipp Lurz
(8)
,
Philippe Gosse
(9)
,
Kintur Sanghvi
,
Naomi Fisher
(10)
,
Lars Rump
(11)
,
Atul Pathak
(12)
,
Peter Blankestijn
(13)
,
Anthony Mathur
(1)
,
Yale Wang
(14)
,
Michael Weber
(15)
,
Andrew Sharp
(16, 17)
,
Michael Bloch
(18)
,
Neil Barman
,
Lisa Claude
,
Yang Song
(19)
,
Michel Azizi
(20, 21, 22)
,
Melvin Lobo
(1)
1
QMUL -
Queen Mary University of London
2 FAU - Friedrich-Alexander Universität Erlangen-Nürnberg = University of Erlangen-Nuremberg
3 CUMC - Columbia University Medical Center
4 MIT - Massachusetts Institute of Technology
5 UKS - Saarland University Hospital
6 Erasmus MC - Erasmus University Medical Center [Rotterdam]
7 MUSC - Medical University of South Carolina [Charleston]
8 Leipzig University / Universität Leipzig
9 Hôpital Saint-André
10 BWH - Brigham & Women’s Hospital [Boston]
11 University Hospital Düsseldorf
12 Centre Hospitalier Princesse Grace
13 University Medical Center [Utrecht]
14 Minneapolis Heart Institute
15 SUNY - State University of New York
16 UHW - University Hospital of Wales
17 University of Exeter
18 University of Nevada [Reno]
19 Baim Institute for Clinical Research Boston MA
20 CIC 1418 - CIC - HEGP
21 DMU CARTE - CArdiovasculaire Rénal Transplantation nEurovasculaire [Paris]
22 HEGP - Hôpital Européen Georges Pompidou [APHP]
2 FAU - Friedrich-Alexander Universität Erlangen-Nürnberg = University of Erlangen-Nuremberg
3 CUMC - Columbia University Medical Center
4 MIT - Massachusetts Institute of Technology
5 UKS - Saarland University Hospital
6 Erasmus MC - Erasmus University Medical Center [Rotterdam]
7 MUSC - Medical University of South Carolina [Charleston]
8 Leipzig University / Universität Leipzig
9 Hôpital Saint-André
10 BWH - Brigham & Women’s Hospital [Boston]
11 University Hospital Düsseldorf
12 Centre Hospitalier Princesse Grace
13 University Medical Center [Utrecht]
14 Minneapolis Heart Institute
15 SUNY - State University of New York
16 UHW - University Hospital of Wales
17 University of Exeter
18 University of Nevada [Reno]
19 Baim Institute for Clinical Research Boston MA
20 CIC 1418 - CIC - HEGP
21 DMU CARTE - CArdiovasculaire Rénal Transplantation nEurovasculaire [Paris]
22 HEGP - Hôpital Européen Georges Pompidou [APHP]
Manish Saxena
- Fonction : Auteur
- PersonId : 805330
- ORCID : 0000-0001-9964-2692
Roland Schmieder
- Fonction : Auteur
- PersonId : 756878
- ORCID : 0000-0003-2356-5883
Ajay Kirtane
- Fonction : Auteur
- PersonId : 805868
- ORCID : 0000-0003-0061-1058
Felix Mahfoud
- Fonction : Auteur
- PersonId : 786704
- ORCID : 0000-0002-4425-549X
Philippe Gosse
- Fonction : Auteur
- PersonId : 786068
- ORCID : 0000-0002-5840-7749
- IdRef : 034240071
Kintur Sanghvi
- Fonction : Auteur
Atul Pathak
- Fonction : Auteur
- PersonId : 761567
- ORCID : 0000-0001-6151-0096
- IdRef : 058662421
Yale Wang
- Fonction : Auteur
- PersonId : 805329
- ORCID : 0000-0002-8780-5113
Michael Weber
- Fonction : Auteur
- PersonId : 801290
- ORCID : 0000-0002-8504-0831
Neil Barman
- Fonction : Auteur
- PersonId : 823327
- ORCID : 0000-0001-5713-6716
Lisa Claude
- Fonction : Auteur
- PersonId : 800876
- ORCID : 0000-0002-0418-5888
Yang Song
- Fonction : Auteur
- PersonId : 772683
- ORCID : 0000-0001-9921-0718
- IdRef : 263493865
Michel Azizi
- Fonction : Auteur
- PersonId : 759639
- ORCID : 0000-0002-0815-0586
Melvin Lobo
- Fonction : Auteur
- PersonId : 805869
- ORCID : 0000-0002-1122-948X
Résumé
Abstract The blood pressure (BP) lowering response to renal denervation (RDN) remains variable with about one-third of patients not responding to ultrasound or radiofrequency RDN. Identification of predictors of the BP response to RDN is needed to optimize patient selection for this therapy. This is a post-hoc analysis of the RADIANCE-HTN SOLO study. BP response to RDN was measured by the change in daytime ambulatory systolic blood pressure (dASBP) at 2 months post procedure. Univariate regression was used initially to assess potential predictors of outcome followed by multivariate regression analysis. In the univariate analysis, predictors of response to RDN were higher baseline daytime ambulatory diastolic blood pressure (dADBP), the use of antihypertensive medications at screening, and presence of orthostatic hypertension (OHTN) whilst the presence of untreated accessory arteries was a negative predictor of response. Multivariate analysis determined that dADBP and use of antihypertensive medications were predictors of response to RDN with a trend for OHTN to predict response. Obese females also appeared to be better responders to RDN in an interaction model. RDN is more effective in patients with elevated baseline dADBP and those with OHTN, suggesting increased peripheral vascular resistance secondary to heightened sympathetic tone. These assessments are easy to perform in clinical setting and may help in phenotyping patients who will respond better to RDN.