# Pulsatiele hemodynamiek voorspelt bloeddrukrespons op renale denervatie

*geplaatst 2022-07-01 · Hartfalen · Hypertension (Dallas, Tex. : 1979) · doi 10.1161/HYPERTENSIONAHA.121.18641 · https://hartvaat.nl/2022/07/01/pulsatiele-hemodynamiek-voorspelt-bloeddrukrespons-op-renale-denervatie/*

Analyse van de SPYRAL HTN-OFF MED-trial toonde dat 24-uurs pulsatiele hemodynamische parameters de bloeddrukrespons op renale denervatie voorspellen. Hogere uitgangspolsdruk en augmentatie-index waren geassocieerd met een grotere bloeddrukdaling, wat patiëntselectie kan verbeteren.

## English: Twenty-Four-Hour Pulsatile Hemodynamics Predict Brachial Blood Pressure Response to Renal Denervation in the SPYRAL HTN-OFF MED Trial.

This SPYRAL HTN-OFF MED analysis showed that 24-hour pulsatile hemodynamic parameters predict the blood pressure response to renal denervation, enabling individualized patient selection for device-based therapy.

## Abstract (original, from the publication)

BACKGROUND: Renal denervation (RDN) lowers blood pressure (BP), but BP response is variable in individual patients. We investigated whether measures of pulsatile hemodynamics, obtained during 24-hour ambulatory BP monitoring, predict BP drop following RDN. METHODS: From the randomized, sham-controlled SPYRAL HTN-OFF MED Pivotal trial, we performed a post hoc analysis of BP waveforms from 111 RDN patients and 111 sham controls, obtained with a brachial cuff-based sphygmomanometer. Waveforms were acquired during ambulatory BP monitoring at diastolic BP level and processed with validated ARCSolver algorithms to derive hemodynamic parameters (augmentation index; augmentation pressure; backward and forward wave amplitude; estimated aortic pulse wave velocity). We investigated the relationship between averaged 24-hour values at baseline and the change in 24-hour BP at 3 months in RDN patients, corrected for observed trends in the sham group. RESULTS: There was a consistent inverse relationship between baseline augmentation index/augmentation pressure/backward wave amplitude/forward wave amplitude/estimated aortic pulse wave velocity and BP response to RDN: the decrease in 24-hour systolic BP/diastolic BP was 7.8/5.9 (augmentation index), 8.0/6.3 (augmentation pressure), 6.7/5.4 (backward wave amplitude), 5.7/4.7 (forward wave amplitude), and 7.8/5.2 (estimated aortic pulse wave velocity) mm Hg greater for patients below versus above the respective median value (P<0.001 for all comparisons, respectively). Taking augmentation index/augmentation pressure/backward wave amplitude/forward wave amplitude/estimated aortic pulse wave velocity into account, a favorable BP response following RDN, defined as a drop in 24-hour systolic blood pressure of ≥5 mm Hg, could be predicted with an area under the curve of 0.70/0.74/0.70/0.65/0.62 (P<0.001 for all, respectively). CONCLUSIONS: These results suggest that pulsatile hemodynamics, obtained during 24-hour ambulatory BP monitoring, may predict BP response to RDN.

Auteurs: Thomas Weber, Siegfried Wassertheurer, Christopher C Mayer, Bernhard Hametner, Kathrin Danninger, Raymond R Townsend, Felix Mahfoud, Kazuomi Kario, Martin Fahy, Vanessa DeBruin, Nicole Peterson, Manuela Negoita, Michael A Weber, David E Kandzari, Roland E Schmieder, Konstantinos P Tsioufis, Ronald K Binder, Michael Böhm

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Bron: Hypertension (Dallas, Tex. : 1979), https://doi.org/10.1161/HYPERTENSIONAHA.121.18641. Bijgewerkt 2026-07-03T18:38:53Z. Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.