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Biomarkers. 2017 May - Jun;22(3-4):225-231. doi: 10.3109/1354750X.2016.1172112. Epub 2016 May 6.

Biomarker response and therapy prediction in renal denervation therapy - the role of MR-proadrenomedullin in a multicenter approach.

Author information

1
a Department of General and Interventional Cardiology , Hamburg University Heart Center , Hamburg , Germany.
2
b Department of Cardiology and Division of Emergency Medicine, Campus Virchow Klinikum and Campus Charité Mitte , Charité Universitätsmedizin Berlin , Germany.
3
c Department of Internal Medicine I, Cardiology/Angiology , Giessen University , Giessen , Germany.
4
d Department of Medical Clinic II, Cardiology , University of Lübeck , Lübeck , Germany.

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.

KEYWORDS:

ADM; adrenomedullin; biomarkers; hypertension; renal denervation; responder

PMID:
27153479
DOI:
10.3109/1354750X.2016.1172112
[Indexed for MEDLINE]

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