Background and objectives The plasma concentration of the endogenous inhibitor of nitric oxide synthase asymmetric dimethylarginine (ADMA) associates with sympathetic activity in patients with CKD, but the driver of this association is unknown. Design, setting, participants, &measurements In this longitudinal study (follow-up: 2weeks–6months), repeated measurements over time ofmuscle sympathetic nerve activity corrected (MSNAC), plasma levels of ADMA and symmetric dimethylarginine (SDMA), and BP and heart rate were performed in 14 patients with drug-resistant hypertensionwho underwent bilateral renal denervation (enrolled in 2013 and followed-up until February 2014). Stability of ADMA, SDMA, BP, and MSNAC over time (6 months) was assessed in two historical control groups of patients maintained on stable antihypertensive treatment. Results Time-integrated changes in MSNAC after renal denervation ranged from –40.6% to 10% (average, –15.1%), and these changes were strongly associated with the corresponding changes in plasma ADMA (r= 0.62, P=0.02) and SDMA (r=0.72, P=0.004). Changes in MSNAC went along with simultaneous changes in standardized systolic (r=0.65, P=0.01) and diastolic BP (r=0.61, P=0.02). In the historical control groups, no change in ADMA, SDMA, BP, and MSNAC levels was recorded during a 6-month follow-up. Conclusions In patients with resistant hypertension, changes in sympathetic activity after renal denervation associatewith simultaneous changes in plasma levels of the two major endogenousmethylarginines,ADMA and SDMA. These observations are compatible with the hypothesis that the sympathetic nervous system exerts an important role in modulating circulating levels of ADMA and SDMA in this condition.

Grassi, G., Seravalle, G., QUARTI TREVANO, F., Spaziani, D., Scalise, F., Auguadro, C., et al. (2015). Asymmetric and Symmetric Dimethylarginine and Sympathetic Nerve Traffic after Renal Denervation in Patients with Resistant Hypertension. CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 10(9), 1560-1567 [10.2215/CJN.01220215].

Asymmetric and Symmetric Dimethylarginine and Sympathetic Nerve Traffic after Renal Denervation in Patients with Resistant Hypertension

GRASSI, GUIDO
Primo
;
QUARTI TREVANO, FOSCA ANNA LUISA;MANCIA, GIUSEPPE
Penultimo
;
2015

Abstract

Background and objectives The plasma concentration of the endogenous inhibitor of nitric oxide synthase asymmetric dimethylarginine (ADMA) associates with sympathetic activity in patients with CKD, but the driver of this association is unknown. Design, setting, participants, &measurements In this longitudinal study (follow-up: 2weeks–6months), repeated measurements over time ofmuscle sympathetic nerve activity corrected (MSNAC), plasma levels of ADMA and symmetric dimethylarginine (SDMA), and BP and heart rate were performed in 14 patients with drug-resistant hypertensionwho underwent bilateral renal denervation (enrolled in 2013 and followed-up until February 2014). Stability of ADMA, SDMA, BP, and MSNAC over time (6 months) was assessed in two historical control groups of patients maintained on stable antihypertensive treatment. Results Time-integrated changes in MSNAC after renal denervation ranged from –40.6% to 10% (average, –15.1%), and these changes were strongly associated with the corresponding changes in plasma ADMA (r= 0.62, P=0.02) and SDMA (r=0.72, P=0.004). Changes in MSNAC went along with simultaneous changes in standardized systolic (r=0.65, P=0.01) and diastolic BP (r=0.61, P=0.02). In the historical control groups, no change in ADMA, SDMA, BP, and MSNAC levels was recorded during a 6-month follow-up. Conclusions In patients with resistant hypertension, changes in sympathetic activity after renal denervation associatewith simultaneous changes in plasma levels of the two major endogenousmethylarginines,ADMA and SDMA. These observations are compatible with the hypothesis that the sympathetic nervous system exerts an important role in modulating circulating levels of ADMA and SDMA in this condition.
Articolo in rivista - Articolo scientifico
ADMA; CKD; hypertension; renal denervation
English
2015
10
9
1560
1567
open
Grassi, G., Seravalle, G., QUARTI TREVANO, F., Spaziani, D., Scalise, F., Auguadro, C., et al. (2015). Asymmetric and Symmetric Dimethylarginine and Sympathetic Nerve Traffic after Renal Denervation in Patients with Resistant Hypertension. CLINICAL JOURNAL OF THE AMERICAN SOCIETY OF NEPHROLOGY, 10(9), 1560-1567 [10.2215/CJN.01220215].
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/111031
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