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Original Article

Soluble fms-Like Tyrosine Kinase-1 and Endothelial Adhesion Molecules (Intercellular Cell Adhesion Molecule-1 and Vascular Cell Adhesion Molecule-1) as Predictive Markers for Blood Pressure Reduction After Renal Sympathetic Denervation

Oliver Dörr, Christoph Liebetrau, Helge Möllmann, Luise Gaede, Christian Troidl, Johannes Rixe, Christian Hamm, Holger Nef
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https://doi.org/10.1161/HYPERTENSIONAHA.113.02266
Hypertension. 2014;HYPERTENSIONAHA.113.02266
Originally published January 27, 2014
Oliver Dörr
From the Department of Cardiology, University of Giessen, Giessen, Germany (O.D., J.R., C.H., H.N.); and Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., H.M., L.G., C.T., C.H.).
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Christoph Liebetrau
From the Department of Cardiology, University of Giessen, Giessen, Germany (O.D., J.R., C.H., H.N.); and Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., H.M., L.G., C.T., C.H.).
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Helge Möllmann
From the Department of Cardiology, University of Giessen, Giessen, Germany (O.D., J.R., C.H., H.N.); and Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., H.M., L.G., C.T., C.H.).
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Luise Gaede
From the Department of Cardiology, University of Giessen, Giessen, Germany (O.D., J.R., C.H., H.N.); and Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., H.M., L.G., C.T., C.H.).
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Christian Troidl
From the Department of Cardiology, University of Giessen, Giessen, Germany (O.D., J.R., C.H., H.N.); and Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., H.M., L.G., C.T., C.H.).
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Johannes Rixe
From the Department of Cardiology, University of Giessen, Giessen, Germany (O.D., J.R., C.H., H.N.); and Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., H.M., L.G., C.T., C.H.).
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Christian Hamm
From the Department of Cardiology, University of Giessen, Giessen, Germany (O.D., J.R., C.H., H.N.); and Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., H.M., L.G., C.T., C.H.).
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Holger Nef
From the Department of Cardiology, University of Giessen, Giessen, Germany (O.D., J.R., C.H., H.N.); and Department of Cardiology, Kerckhoff Heart and Thorax Center, Bad Nauheim, Germany (C.L., H.M., L.G., C.T., C.H.).
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Abstract

Renal sympathetic denervation (RSD) is a treatment option for patients with resistant arterial hypertension, but in some patients it is not successful. Predictive parameters on the success of RSD remain unknown. The angiogenic factors soluble fms-like tyrosine kinase-1 (sFLT-1), intercellular cell adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule-1 (VCAM-1) are known to be associated with endothelial dysfunction, vascular remodeling, and hypertension. We evaluated whether sFLT-1, ICAM-1, and VCAM-1 are predictive markers for blood pressure reduction after RSD. Consecutive patients (n=55) undergoing renal denervation were included. Venous serum samples for measurement of sFlt-1, ICAM-1, and VCAM-1 were collected before and 6 months after RSD. A therapeutic response was defined as an office systolic blood pressure reduction of >10 mm Hg 6 months after RSD. A significant mean office systolic blood pressure reduction of 31.2 mm Hg was observed in 46 patients 6 months after RSD. Nine patients were classified as nonresponders, with a mean systolic blood pressure reduction of 4.6 mm Hg. At baseline, sFLT-1 levels were significantly higher in responders than in nonresponders (P<0.001) as were ICAM-1 (P<0.001) and VCAM-1 levels (P<0.01). The areas under the curve for sFLT-1, ICAM-1, and VCAM-1 were 0.82 (interquartile range, 0.718–0.921; P<0.001), 0.754 (0.654–0.854; P<0.001), and 0.684 (0.564–804; P=0.01), respectively, demonstrating prediction of an RSD response. Responders showed significantly higher serum levels of sFLT-1, ICAM-1, and VCAM-1 at baseline compared with nonresponders. Thus, this study identified for the first time potential biomarkers with a predictive value indicating a responder or nonresponder before renal denervation.

  • biological markers
  • hypertension
  • Received August 20, 2013.
  • Revision received September 8, 2013.
  • Accepted December 11, 2013.
  • © 2014 American Heart Association, Inc.
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    Soluble fms-Like Tyrosine Kinase-1 and Endothelial Adhesion Molecules (Intercellular Cell Adhesion Molecule-1 and Vascular Cell Adhesion Molecule-1) as Predictive Markers for Blood Pressure Reduction After Renal Sympathetic Denervation
    Oliver Dörr, Christoph Liebetrau, Helge Möllmann, Luise Gaede, Christian Troidl, Johannes Rixe, Christian Hamm and Holger Nef
    Hypertension. 2014;HYPERTENSIONAHA.113.02266, originally published January 27, 2014
    https://doi.org/10.1161/HYPERTENSIONAHA.113.02266

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    Soluble fms-Like Tyrosine Kinase-1 and Endothelial Adhesion Molecules (Intercellular Cell Adhesion Molecule-1 and Vascular Cell Adhesion Molecule-1) as Predictive Markers for Blood Pressure Reduction After Renal Sympathetic Denervation
    Oliver Dörr, Christoph Liebetrau, Helge Möllmann, Luise Gaede, Christian Troidl, Johannes Rixe, Christian Hamm and Holger Nef
    Hypertension. 2014;HYPERTENSIONAHA.113.02266, originally published January 27, 2014
    https://doi.org/10.1161/HYPERTENSIONAHA.113.02266
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