E1744 JACC March 12, 2013 Volume 61, Issue 10 TCT@ACC-i2: Invasive and Interventional Cardiology IMPACT OF RENAL DENERVATION ON THE PERIPROCEDURAL NOREPINEPHRINE RELEASE FROM RENAL NERVES Oral Contributions West, Room 2009 Sunday, March 10, 2013, 8:15 a.m.-8:25 a.m. Session Title: Endovascular Intervention and Renal Denervation Abstract Category: 41. TCT@ACC-i2: Carotid, Neurovascular, and Endovascular Intervention Presentation Number: 2905-3 Authors: Klaus A. Tiroch, Jacek Szymanski, Armin Sause, Marc Vorpahl, Melchior Seyfarth, HELIOS Klinikum, Wuppertal, Germany Background: Renal denervation (RDN) is a promising new treatment option. Only 70% of patients have a relevant reduction in blood pressure (BP) three to six months after RDN when assessed by systematic 24h BP measurements. No variables have been identified to date predicting the BP response. Methods: We assessed 14 patients with bilateral renal denervation for the changes of pre- and postprocedural norepinephrine (NE) and epinephrine (E) levels measured directly from the renal artery (RA) and vein (RV). We defined the respective spillover for ΔNE and ΔE as the difference RV-RA and compared this difference before and after the procedure. Results: We assessed NE and E for 112 probes (14 patients x 2 (bilateral probes) x 2(RA and RV) x 2(pre- and post-procedural)). There was a significant decrease of the ΔNE RV-RA spill-over comparing pre- with post-procedural levels (189pg/ml±170 decrease to 91pg/ml±122, P=0.03 for paired t-test). There was no significant change in the epinephrine levels during the procedure under conscious sedation (54pg/ml±177 compared to 34pg/ml±161, P=0.71 for paired t-test). The pre-post ΔNE RV-RA was even more pronounced when the median values were compared (P = 0.02). Conclusions: The decrease of norepinephrine veno-arterial difference during RDN is a readily assessable marker reflecting the disconnection of renal sympathetic nerves. The systematic follow-up of our patients will allow the evaluation of the prognostic value of norepinephrine spillover decrease with the BP response.

IMPACT OF RENAL DENERVATION ON THE PERIPROCEDURAL NOREPINEPHRINE RELEASE FROM RENAL NERVES

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Page 1: IMPACT OF RENAL DENERVATION ON THE PERIPROCEDURAL NOREPINEPHRINE RELEASE FROM RENAL NERVES

E1744JACC March 12, 2013Volume 61, Issue 10

TCT@ACC-i2: Invasive and Interventional CardiologyimpacT of renal denervaTion on The periprocedural norepinephrine release from renal nerves

Oral ContributionsWest, Room 2009Sunday, March 10, 2013, 8:15 a.m.-8:25 a.m.

Session Title: Endovascular Intervention and Renal DenervationAbstract Category: 41. TCT@ACC-i2: Carotid, Neurovascular, and Endovascular InterventionPresentation Number: 2905-3

Authors: Klaus A. Tiroch, Jacek Szymanski, Armin Sause, Marc Vorpahl, Melchior Seyfarth, HELIOS Klinikum, Wuppertal, Germany

Background: Renal denervation (RDN) is a promising new treatment option. Only 70% of patients have a relevant reduction in blood pressure (BP) three to six months after RDN when assessed by systematic 24h BP measurements. No variables have been identified to date predicting the BP response.

methods: We assessed 14 patients with bilateral renal denervation for the changes of pre- and postprocedural norepinephrine (NE) and epinephrine (E) levels measured directly from the renal artery (RA) and vein (RV). We defined the respective spillover for ΔNE and ΔE as the difference RV-RA and compared this difference before and after the procedure.

results: We assessed NE and E for 112 probes (14 patients x 2 (bilateral probes) x 2(RA and RV) x 2(pre- and post-procedural)). There was a significant decrease of the ΔNE RV-RA spill-over comparing pre- with post-procedural levels (189pg/ml±170 decrease to 91pg/ml±122, P=0.03 for paired t-test). There was no significant change in the epinephrine levels during the procedure under conscious sedation (54pg/ml±177 compared to 34pg/ml±161, P=0.71 for paired t-test). The pre-post ΔNE RV-RA was even more pronounced when the median values were compared (P = 0.02).

conclusions: The decrease of norepinephrine veno-arterial difference during RDN is a readily assessable marker reflecting the disconnection of renal sympathetic nerves. The systematic follow-up of our patients will allow the evaluation of the prognostic value of norepinephrine spillover decrease with the BP response.