New System Could Hold Promise for Patients Suffering from Pulmonary Arterial Hypertension

SoniVie’s recent clinical trial of TIVUS (therapeutic intravascular ultrasound) shows encouraging results for patients with pulmonary arterial hypertension (PAH). “The TROPHY1 study was our first human study in patients with pulmonary arterial hypertension,” said Charles Carignan, MD, CEO of SoniVie, in an interview with MD+DI. The results are from a 6-month follow-up for the 23 enrolled WHO Class 3 patients in the United States, Europe, and Israel. TIVUS is a catheter that goes either through the jugular vein or the femoral vein into the right side of the heart and passes through the heart into the pulmonary artery. The procedure takes place in a typical cardiac catheterization lab, and the whole procedure takes about 30 minutes more time than a traditional right heart catheterization procedure. TIVUS has three ultrasound arrays at the distal tip, which create sound waves that heat up the nerves around the pulmonary artery. This causes those nerves to necrose and die, which then interrupts the signaling around the artery. “What we believe happens then is that you lose the sympathetic output, so the neurochemicals that would normally be released from those nerves that cause narrowing of the artery are not released,” said Carignan. “This allows the artery to relax and that then reduces the pressure in the pulmonary artery and that reduces the work that the right side of ...
Source: MDDI - Category: Medical Devices Authors: Tags: Business Source Type: news

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AbstractPurpose of the ReviewHyperactivity of sympathetic nervous system (SNS) plays a role in the development of arterial hypertension and heart failure, two co-morbidities frequently associated with type 2 diabetes (T2DM). This review aims at analyzing the effects of sodium-glucose cotransporter type 2 inhibitors (SGLT2is) on blood pressure and more especially on SNS activity in patients with T2DM.Recent FindingsBy enhancing glucosuria, natriuresis, and osmotic diuresis, SGLT2is improve glucose control, promote weight loss, lower arterial blood pressure, and reduce the risk of major cardiovascular events and hospitalizat...
Source: Current Cardiology Reports - Category: Cardiology Source Type: research
(University of South Florida (USF Innovation)) Using a rat model for high blood pressure (hypertension), a common chronic cardiovascular condition, a University of South Florida team found that preexisting hypertension altered normal reflexes in the lungs to affect autonomic regulation of the heart when an irritant mimicking air pollution was inhaled. In particular, hypertension appeared to shift the reflex response from the 'fight-or-flight' parasympathetic nervous system to the sympathetic nervous system, which controls involuntary responses like heart rate while the body is at rest.
Source: EurekAlert! - Medicine and Health - Category: International Medicine & Public Health Source Type: news
Abnormal sympathetic hyperactivity has been shown to lead to pulmonary arterial hypertension (PAH) deterioration. The purpose of this study was to examine whether the transection of the cervical sympathetic tr...
Source: Respiratory Research - Category: Respiratory Medicine Authors: Tags: Research Source Type: research
Authors: Bolignano D, Coppolino G Abstract Hypertension remains a major public health problem and one of the most relevant causes of cardiovascular mortality and morbidity worldwide. Roughly 10% of hypertensive individuals are considered as "resistant" as they are not able to achieve and maintain optimal blood pressure values despite the concurrent use of 3 antihypertensive agents of different classes at optimal doses. As resistant hypertension conveys a higher risk of adverse outcomes, the search for effective treatments to properly manage this condition has progressively surged as a true health priority...
Source: Reviews in Cardiovascular Medicine - Category: Cardiology Tags: Rev Cardiovasc Med Source Type: research
Authors: Sano M Abstract It has become clear that sodium glucose cotransporter (SGLT)-2 inhibitors not only do not increase the incidence of cardiovascular events but they also reduce the duration of hospitalization for heart failure in type 2 diabetic (T2DM) patients. The administration of SGLT2 inhibitor in T2DM patients with hypertension and a fluid retention tendency lowers the blood pressure and mitigates fluid retention. It also reduces the heart rate in T2DM patients with a fast heart rate. As an explanation for the multifaceted effects of SGLT2 inhibitors on hemodynamics, we hypothesize that these agents ac...
Source: Internal Medicine - Category: Internal Medicine Tags: Intern Med Source Type: research
AbstractPurpose of ReviewThis review seeks to present an overview of the recently found association between refractory hypertension (RfH) and obstructive sleep apnoea (OSA).Recent FindingsRfH was recently defined as an extreme phenotype of resistant hypertension characterized by the lack of blood pressure control despite using ≥ 5 antihypertensive drugs at optimal doses. Current data support that the pathophysiological pathway of both types of hypertension is different. The main mechanism involved in resistant hypertension is fluid retention whereas in the case of RfH is the sympathetic over-activity. OSA is now ...
Source: Current Hypertension Reports - Category: Primary Care Source Type: research
Purpose of review Patients with severe orthostatic hypotension due to autonomic failure may be hypertensive in the supine position. Until recently, there were no internationally recognized diagnostic criteria for supine hypertension. This review covers diagnostic criteria, mechanisms, and management of supine hypertension in autonomic failure patients. Recent findings Recently, an international consensus group defined supine hypertension in patients with neurogenic orthostatic hypotension as brachial SBP at least 140 mmHg and/or DBP at least 90 mmHg while supine. Using these criteria, a large proportion of patient...
Source: Current Opinion in Cardiology - Category: Cardiology Tags: HYPERTENSION: Edited by Hector O. Ventura and Carl J. Lavie Source Type: research
Publication date: Available online 7 June 2019Source: NeuroscienceAuthor(s): Garrett M. Fogo, Dorela D. Shuboni-Mulligan, Andrew J. GallAbstractIntrinsically photosensitive retinal ganglion cells (ipRGCs) are critical for the light signaling properties of non-image forming vision. Melanopsin-expressing ipRGCs project to retinorecipient brain regions involved in modulating circadian rhythms. Melanopsin has been shown to play an important role in how animals respond to light, including photoentrainment, masking (i.e., acute behavioral responses to light), and the pupillary light reflex (PLR). Importantly, ipRGCs are resistan...
Source: Neuroscience - Category: Neuroscience Source Type: research
CONCLUSIONS: Cholinergic activation of CD161a+ positive immune cells leads to the premature development of hypertension in SHR, at least partly, through increased renal expression of NKCC2 and renal sodium retention. Effects on chemotaxis of CD161a+ macrophages to the renal medulla, decreased renal expression of NKCC2, and renal sodium retention appear to play a part in the prevention of cholinergic hypertension as a result of RND. The CD161a+ immune cells are necessary and essential for this pro-hypertensive nicotine-mediated inflammatory response. PMID: 31172810 [PubMed - as supplied by publisher]
Source: American Journal of Physiology. Heart and Circulatory Physiology - Category: Physiology Authors: Tags: Am J Physiol Heart Circ Physiol Source Type: research
Ion channels play as a pivotal role in hypertension in the processes of maintenance of vascular tone and sympathetic excitement of hypertension. The Kv10.2 channel (encoded by the Kcnh5 gene) belongs to the EAG voltage-gated superfamily. It is distributed widely in the brain, such as the hippocampus, the cortex, and the olfactory bulb. To date, the expression of Kv10.2 in central nervous system nuclei that regulates cardiovascular function and its inter-relationship with hypertension are still unclear. Here, electric foot-shock stressors with noise were used to establish the stress-induced hypertensive (SIH) rat model. The...
Source: NeuroReport - Category: Neurology Tags: CLINICAL NEUROSCIENCE Source Type: research
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