{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T23:51:21Z","timestamp":1792713081242,"version":"4.5.0"},"reference-count":23,"publisher":"Bentham Science Publishers Ltd.","issue":"1","license":[{"start":{"date-parts":[[2016,7,29]],"date-time":"2016-07-29T00:00:00Z","timestamp":1469750400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/legalcode"}],"content-domain":{"domain":["opencardiovascularmedicinejournal.com","benthamopen.com"],"crossmark-restriction":true},"short-container-title":["TOCMJ"],"published-print":{"date-parts":[[2016,7,29]]},"abstract":"<jats:sec><jats:title>Background:<\/jats:title><jats:p>The Symplicity-HTN 3 trial failed to show significant difference in blood pressure (BP) lowering between patients undergoing catheter-based renal denervation (RDN) and the sham-procedure arm of the study. However, there is still optimism about the role of RDN in the treatment of resistant hypertension, because identification of patients with increased sympathetic activity thus being good RDN responders, improvements in the RDN procedure and new technology RDN catheters are all expected to lead to better RDN results. We present our initial experience with RDN for the treatment of resistant hypertension, and the utility of novel anesthetics and cardiac<jats:sup>123<\/jats:sup>I-metaiodobenzylguanidine scintigraphy (<jats:sup>123<\/jats:sup>I-MIBG).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and Results:<\/jats:title><jats:p>Seven patients with resistant hypertension underwent RDN and were followed up for 6 months. MIBG was performed before RDN, in order to estimate sympathetic activity and predict the response to RDN. All patients were sedated with dexmedetomidine and remifentanil during RDN. All patients tolerated the procedure well, were hemodynamically stable and their peri-procedural pain was effectively controlled. A median of 7.6 \u00b1 2.1 and 6 \u00b1 1.4 ablations were delivered in the right and left renal artery respectively, making an average of 6.8 burns per artery. No peri-procedural or late complications - adverse events (local or systematic) occurred. At 6 months, mean reduction in office BP was -26.0\/-16.3 mmHg (<jats:italic>p<\/jats:italic>=0.004\/<jats:italic>p<\/jats:italic>=0.02), while mean reduction in ambulatory BP was -12.3\/-9.2 mmHg (<jats:italic>p<\/jats:italic>=0.118\/<jats:italic>p<\/jats:italic>=0.045). One patient (14.3%) was a non-responder. None of the cardiac<jats:sup>123<\/jats:sup>I-MIBG imaging indexes(early and late heart-to-mediastinum (H\/M) count density ratio, washout rate (WR) of the tracer from the myocardium) were different between responders and non-responders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion:<\/jats:title><jats:p>Patients with resistant hypertension who underwent RDN in our department had a significant reduction in BP 6 months after the intervention.<jats:sup>123<\/jats:sup>I-MIBG was not useful in predicting RDN response. Dexmedetomidine and remifentanil provided sufficient patient comfort during the procedure, allowing an adequate number of ablations per renal artery to be performed, and this could probably lead to improved RDN results.<\/jats:p><\/jats:sec>","DOI":"10.2174\/1874192401610010163","type":"journal-article","created":{"date-parts":[[2016,8,3]],"date-time":"2016-08-03T04:32:01Z","timestamp":1470198721000},"page":"163-170","update-policy":"https:\/\/doi.org\/10.2174\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Initial Experience with Renal Denervation for the Treatment of Resistant Hypertension - The Utility of Novel Anesthetics and Metaiodobenzylguanidine Scintigraphy (MIBG)"],"prefix":"10.2174","volume":"10","author":[{"given":"Antonios","family":"Ziakas","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dimitrios","family":"Petroglou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Efstratios","family":"Moralidis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Tsioufis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mihalis","family":"Doumas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elena","family":"Argiriadou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos","family":"Savopoulos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stavros","family":"Hadjimiltiades","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ioannis","family":"Stiliadis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonios","family":"Kouparanis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sotirios","family":"Katranas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonidas","family":"Lillis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Athanasios","family":"Koutsakis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haralambos","family":"Karvounis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"965","reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"790","DOI":"10.4103\/0366-6999.152621","volume":"128","author":"Ji M.","year":"2015","unstructured":"Ji M, Shen L, Wu YZ, et al. Short-term safety and efficiency of cryoablation for renal sympathetic denervation in a swine model. Chin Med J (Engl) 2015; 128 (6) : 790-4.","journal-title":"Chin. Med. J. (Engl.)"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"932","DOI":"10.1056\/NEJMc0904179","volume":"361","author":"Schlaich M.P.","year":"2009","unstructured":"Schlaich MP, Sobotka PA, Krum H, Lambert E, Esler MD. Renal sympathetic-nerve ablation for uncontrolled hypertension. N Engl J Med 2009; 361 (9) : 932-4.","journal-title":"N. Engl. J. Med."},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1275","DOI":"10.1016\/S0140-6736(09)60566-3","volume":"373","author":"Krum H.","year":"2009","unstructured":"Krum H, Schlaich M, Whitbourn R, et al. Catheter-based renal sympathetic denervation for resistant hypertension: a multicentre safety and proof-of-principle cohort study. Lancet 2009; 373 (9671) : 1275-81.","journal-title":"Lancet"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"622","DOI":"10.1016\/S0140-6736(13)62192-3","volume":"383","author":"Krum H.","year":"2014","unstructured":"Krum H, Schlaich MP, Sobotka PA, et al. Percutaneous renal denervation in patients with treatment-resistant hypertension: final 3-year report of the Symplicity HTN-1 study. Lancet 2014; 383 (9917) : 622-9.","journal-title":"Lancet"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1752","DOI":"10.1093\/eurheartj\/ehu209","volume":"35","author":"Esler M.D.","year":"2014","unstructured":"Esler MD, B\u00f6hm M, Sievert H, et al. Catheter-based renal denervation for treatment of patients with treatment-resistant hypertension: 36 month results from the SYMPLICITY HTN-2 randomized clinical trial. Eur Heart J 2014; 35 (26) : 1752-9.","journal-title":"Eur. Heart J."},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1393","DOI":"10.1056\/NEJMoa1402670","volume":"370","author":"Bhatt D.L.","year":"2014","unstructured":"Bhatt DL, Kandzari DE, O\u2019Neill WW, et al. A controlled trial of renal denervation for resistant hypertension. N Engl J Med 2014; 370 (15) : 1393-401.","journal-title":"N. Engl. J. Med."},{"key":"ref7","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1016\/j.jash.2014.12.002","volume":"9","author":"Epstein M.","year":"2015","unstructured":"Epstein M, de Marchena E. Is the failure of SYMPLICITY HTN-3 trial to meet its efficacy endpoint the \u201cend of the road\u201d for renal denervation? J Am Soc Hypertens 2015; 9 (2) : 140-9.","journal-title":"J. Am. Soc. Hypertens."},{"key":"ref8","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1007\/s12350-012-9655-1","volume":"20","author":"Travin M.I.","year":"2013","unstructured":"Travin MI. Cardiac autonomic imaging with SPECT tracers. J Nucl Cardiol 2013; 20 (1) : 128-43.","journal-title":"J. Nucl. Cardiol."},{"key":"ref9","doi-asserted-by":"publisher","first-page":"1802","DOI":"10.1007\/s00259-010-1491-4","volume":"37","author":"Flotats A.","year":"2010","unstructured":"Flotats A, Carri\u00f3 I, Agostini D, et al. Proposal for standardization of 123I-metaiodobenzylguanidine (MIBG) cardiac sympathetic imaging by the EANM Cardiovascular Committee and the European Council of Nuclear Cardiology. Eur J Nucl Med Mol Imaging 2010; 37 (9) : 1802-12.","journal-title":"Eur. J. Nucl. Med. Mol. Imaging"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1903","DOI":"10.1016\/S0140-6736(10)62039-9","volume":"376","author":"Esler M.D.","year":"2010","unstructured":"Esler MD, Krum H, Sobotka PA, Schlaich MP, Schmieder RE, B\u00f6hm M. Renal sympathetic denervation in patients with treatment-resistant hypertension (The Symplicity HTN-2 Trial): a randomised controlled trial. Lancet 2010; 376 (9756) : 1903-9.","journal-title":"Lancet"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"153","DOI":"10.1213\/01.ANE.0000093225.39866.75","volume":"98","author":"Arain S.R.","year":"2004","unstructured":"Arain SR, Ruehlow RM, Uhrich TD, Ebert TJ. The efficacy of dexmedetomidine versus morphine for postoperative analgesia after major inpatient surgery. Anesth Analg 2004; 98 (1) : 153-8.","journal-title":"Anesth. Analg."},{"key":"ref12","doi-asserted-by":"publisher","first-page":"117","DOI":"10.1093\/bja\/aen320","volume":"102","author":"Lin T.F.","year":"2009","unstructured":"Lin TF, Yeh YC, Lin FS, et al. Effect of combining dexmedetomidine and morphine for intravenous patient-controlled analgesia. Br J Anaesth 2009; 102 (1) : 117-22.","journal-title":"Br. J. Anaesth."},{"key":"ref13","doi-asserted-by":"publisher","first-page":"699","DOI":"10.1097\/00000539-200003000-00035","volume":"90","author":"Hall J.E.","year":"2000","unstructured":"Hall JE, Uhrich TD, Barney JA, Arain SR, Ebert TJ. Sedative, amnestic, and analgesic properties of small-dose dexmedetomidine infusions. Anesth Analg 2000; 90 (3) : 699-705.","journal-title":"Anesth. Analg."},{"key":"ref14","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1093\/eurheartj\/ehu441","volume":"36","author":"Kandzari D.E.","year":"2015","unstructured":"Kandzari DE, Bhatt DL, Brar S, et al. Predictors of blood pressure response in the SYMPLICITY HTN-3 trial. Eur Heart J 2015; 36 (4) : 219-27.","journal-title":"Eur. Heart J."},{"key":"ref15","doi-asserted-by":"crossref","first-page":"351","DOI":"10.3909\/ricm0720","volume":"15","author":"Gomez S.I.","year":"2014","unstructured":"Gomez SI, Urbandt P, Beohar N, Santana O. Renal denervation: current status and future applications. Rev Cardiovasc Med 2014; 15 (4) : 351-7.","journal-title":"Rev. Cardiovasc. Med."},{"key":"ref16","doi-asserted-by":"publisher","first-page":"766","DOI":"10.1161\/HYPERTENSIONAHA.114.05010","volume":"65","author":"B\u00f6hm M.","year":"2015","unstructured":"B\u00f6hm M, Mahfoud F, Ukena C, et al. First report of the Global SYMPLICITY Registry on the effect of renal artery denervation in patients with uncontrolled hypertension. Hypertension 2015; 65 (4) : 766-74.","journal-title":"Hypertension"},{"key":"ref17","unstructured":"Mahfoud F, Mancia G, Schlaich MP, et al. Reduction in office blood pressure after renal denervation in a large real world patient population with uncontrolled hypertension: interim 12-month results from the global symplicity registry . Presented at the European Society of Cardiology; Barcelona. 2014; p. 62."},{"key":"ref18","doi-asserted-by":"publisher","first-page":"642","DOI":"10.1016\/j.cjca.2014.12.004","volume":"31","author":"Briasoulis A.","year":"2015","unstructured":"Briasoulis A, Bakris G. Renal denervation after SYMPLICITY HTN-3: Where do we go? Can J Cardiol 2015; 31 (5) : 642-8.","journal-title":"Can. J. Cardiol."},{"key":"ref19","doi-asserted-by":"publisher","first-page":"1706","DOI":"10.1093\/eurheartj\/ehu195","volume":"35","author":"L\u00fcscher T.F.","year":"2014","unstructured":"L\u00fcscher TF, Mahfoud F. Renal nerve ablation after SYMPLICITY HTN-3: confused at the higher level? Eur Heart J 2014; 35 (26) : 1706-11.","journal-title":"Eur. Heart J."},{"key":"ref20","doi-asserted-by":"publisher","first-page":"2149","DOI":"10.1093\/eurheartj\/eht154","volume":"34","author":"Mahfoud F.","year":"2013","unstructured":"Mahfoud F, L\u00fcscher TF, Andersson B, et al. Expert consensus document from the European Society of Cardiology on catheter-based renal denervation. Eur Heart J 2013; 34 (28) : 2149-57.","journal-title":"Eur. Heart J."},{"key":"ref21","doi-asserted-by":"publisher","first-page":"513","DOI":"10.1152\/physrev.00007.2009","volume":"90","author":"Malpas S.C.","year":"2010","unstructured":"Malpas SC. Sympathetic nervous system overactivity and its role in the development of cardiovascular disease. Physiol Rev 2010; 90 (2) : 513-57.","journal-title":"Physiol. Rev."},{"key":"ref22","doi-asserted-by":"publisher","first-page":"141","DOI":"10.1111\/1755-5922.12116","volume":"33","author":"Lewek J.","year":"2015","unstructured":"Lewek J, Kaczmarek K, Pokushalov E, Romanov A, Cygankiewicz I, Ptaszynski P. Renal denervation--hypes and hopes. Cardiovasc Ther 2015; 33 (3) : 141-4.","journal-title":"Cardiovasc. Ther."},{"key":"ref23","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/j.ejim.2015.01.009","volume":"26","author":"Olsen L.K.","year":"2015","unstructured":"Olsen LK, Kamper AL, Svendsen JH, Feldt-Rasmussen B. Renal denervation. Eur J Intern Med 2015; 26 (2) : 95-105.","journal-title":"Eur. J. Intern. Med."}],"container-title":["The Open Cardiovascular Medicine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/opencardiovascularmedicinejournal.com\/contents\/volumes\/V10\/TOCMJ-10-163\/TOCMJ-10-163.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/opencardiovascularmedicinejournal.com\/contents\/volumes\/V10\/TOCMJ-10-163\/TOCMJ-10-163.xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/opencardiovascularmedicinejournal.com\/contents\/volumes\/V10\/TOCMJ-10-163\/TOCMJ-10-163.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,7,4]],"date-time":"2022-07-04T20:21:38Z","timestamp":1656966098000},"score":1,"resource":{"primary":{"URL":"https:\/\/opencardiovascularmedicinejournal.com\/VOLUME\/10\/PAGE\/163\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,7,29]]},"references-count":23,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2016,7,29]]}},"alternative-id":["TOCMJ-10-163"],"URL":"https:\/\/doi.org\/10.2174\/1874192401610010163","relation":{},"ISSN":["1874-1924"],"issn-type":[{"value":"1874-1924","type":"print"}],"subject":[],"published":{"date-parts":[[2016,7,29]]},"assertion":[{"value":"Peer Reviewed","order":0,"name":"review_status","label":"Review Status","group":{"name":"peer_review_details","label":"Peer Review Details"}},{"value":"Single blind","order":1,"name":"review_process","label":"Review Process","group":{"name":"peer_review_details","label":"Peer Review Details"}},{"value":"Checked with iThenticate","order":0,"name":"screening_status","label":"Screening Status","group":{"name":"plagiarism_screening","label":"Plagiarism Screening"}},{"value":"2016-04-30","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-06-18","order":1,"name":"revised","label":"Revised","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-06-20","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-07-29","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}