Biomarker response and therapy prediction in renal denervation therapy – the role of MR-proadrenomedullin in a multicenter approach. (19th May 2017)

• Record Type: Journal Article
• Authors: Neumann, Johannes Tobias; Schwerg, Marius; Dörr, Oliver; Mortensen, Kai; Franzen, Klaas; Zeller, Tanja; Ojeda, Francisco; Blankenberg, Stefan; Hamm, Christian; Nef, Holger; Stangl, Verena; Möckel, Martin; Sydow, Karsten
• Is Part Of: Biomarkers. Volume 22:Number 3/4(2017)
• Page Start: 225
• Page End: 231
• Publication Date: 2017-05-19
• Subjects: ADM -- adrenomedullin -- biomarkers -- hypertension -- renal denervation -- responder; Biochemical markers -- Periodicals; 610.28
• DOI: 10.3109/1354750X.2016.1172112
• Languages: English
• ISSNs: 1354-750X

Abstract

Abstract: Background: Renal denervation has been proposed as a therapeutic option in patients with resistant hypertension. Circulating blood borne biomarkers might be helpful to identify individuals responding to RDN therapy. MR-proADM is a strong prognostic marker in patients with cardiovascular disease. The aim of this multicenter study was to evaluate the effect of RDN on MR-proADM concentrations. Methods and results: We measured MR-proADM, BNP, and MR-proANP in 110 patients before and after RDN in a multicenter setting. All patients were followed up after 1 and 6 months by office and ambulatory blood pressure (BP) measurements. The mean office BP decreased from 165/89 to 152/87 mmHg 6 months after RDN (systolic: p < 0.001; diastolic: ns), the responder-rate was 74%. Intriguingly MR-proADM concentrations increased from 0.66 to 0.69 nmol/L ( p < 0.001) and were significantly associated with reduction of systolic office BP after 6 months in multivariate analyses (coefficient −0.0018, p < 0.001). In therapy-responders MR-proADM concentrations showed a significantly higher increase over time (coefficient 0.0105, p < 0.05), as compared to non-responders. There were no significant differences in BP change for individuals with low and high baseline MR-proADM (BP-Delta low MR-proADM −23/−4 mmHg vs. high MR-proADM −24/−5 mmHg). The natriuretic biomarkers BNP and MR-proANP did not change significantly after 6 months. Biomarkers at baseline were not able to predict for therapy-responder. Conclusion: In patients undergoing RDN, baseline measurements of various biomarkers had no prognostic use for therapy success in this short time follow-up period in a multicenter approach. Intriguingly, MR-proADM showed a significant association with BP reduction after 6 months.