EuroPCR25th annual meeting of the European Association of Percutaneous Cardiovascular Interventions (EAPCI)

Paris20-23 May 2014

EuroPCR 2014Paris

20-23 May 2014

Moving forward in resistant hypertension using renal denervation:Study updates and results

Commentary:

Associate Professor David EcclestonRoyal Melbourne Hospital

Date of preparation May 2014 │BRI001132

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EuroPCR 2014Paris

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EuroPCR 2014Paris

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EuroPCR 2014Paris

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EuroPCR 2014Paris

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LV mass index reduced despite no improvement in blood pressure in ‘non-responders’

EuroPCR 2014Paris

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EuroPCR 2014Paris

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• A number of new strategies and devices for renal denervation in patients with resistant hypertension were reported at EuroPCR, including the two Australasian studies described in the previous slides.

• Positive results from a number of small studies suggest that renal denervation continues to have potential as an effective treatment, but good outcomes are likely to depend on accurate identification of patients likely to benefit.

• For example, a ‘super responder’ group may include those with an office systolic blood pressure >180 mmHg despite treatment with four or more antihypertensive therapies including spironolactone.

Commentary: Associate Professor David Eccleston

EuroPCR 2014Paris

20-23 May 2014

• There is meaningful progress in developing reliable biomarkers of successful denervation, which will assist in interpreting the blood pressure outcomes observed in clinical studies.

• There are indications in patients with heart failure that sympathetic modulation is beneficial independent of reductions in blood pressure, with reductions in LVH and improved LVEF by MRI.

• Until large randomised studies confirm the safety and efficacy or denervation therapies, they should be restricted to patients enrolled in clinical trials or those who require treatment on compassionate grounds.

Commentary: Associate Professor David Eccleston