Display options
Cite
Narkiewicz K, Ratcliffe LE, Hart EC, et al. Unilateral Carotid Body Resection in Resistant Hypertension: A Safety and Feasibility Trial. JACC Basic Transl Sci. 2016;1(5):313-324doi: 10.1016/j.jacbts.2016.06.004.
Narkiewicz, K., Ratcliffe, L. E., Hart, E. C., Briant, L. J., Chrostowska, M., Wolf, J., Szyndler, A., Hering, D., Abdala, A. P., Manghat, N., Burchell, A. E., Durant, C., Lobo, M. D., Sobotka, P. A., Patel, N. K., Leiter, J. C., Engelman, Z. J., Nightingale, A. K., & Paton, J. F. (2016). Unilateral Carotid Body Resection in Resistant Hypertension: A Safety and Feasibility Trial. JACC. Basic to translational science, 1(5), 313-324. https://doi.org/10.1016/j.jacbts.2016.06.004
Narkiewicz, Krzysztof, et al. "Unilateral Carotid Body Resection in Resistant Hypertension: A Safety and Feasibility Trial." JACC. Basic to translational science vol. 1,5 (2016): 313-324. doi: https://doi.org/10.1016/j.jacbts.2016.06.004
Narkiewicz K, Ratcliffe LE, Hart EC, Briant LJ, Chrostowska M, Wolf J, Szyndler A, Hering D, Abdala AP, Manghat N, Burchell AE, Durant C, Lobo MD, Sobotka PA, Patel NK, Leiter JC, Engelman ZJ, Nightingale AK, Paton JF. Unilateral Carotid Body Resection in Resistant Hypertension: A Safety and Feasibility Trial. JACC Basic Transl Sci. 2016 Aug 29;1(5):313-324. doi: 10.1016/j.jacbts.2016.06.004. eCollection 2016 Aug. PMID: 27766316; PMCID: PMC5063532.
Copy Download .nbib Format: NLM
Share it on

JACC Basic Transl Sci. 2016 Aug 29;1(5):313-324. doi: 10.1016/j.jacbts.2016.06.004. eCollection 2016 Aug.

Unilateral Carotid Body Resection in Resistant Hypertension: A Safety and Feasibility Trial.

JACC. Basic to translational science

Krzysztof Narkiewicz, Laura E K Ratcliffe, Emma C Hart, Linford J B Briant, Marzena Chrostowska, Jacek Wolf, Anna Szyndler, Dagmara Hering, Ana P Abdala, Nathan Manghat, Amy E Burchell, Claire Durant, Melvin D Lobo, Paul A Sobotka, Nikunj K Patel, James C Leiter, Zoar J Engelman, Angus K Nightingale, Julian F R Paton

Affiliations

  1. Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland.
  2. CardioNomics Research Group, Clinical Research & Imaging Centre, University of Bristol and University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom.
  3. CardioNomics Research Group, Clinical Research & Imaging Centre, University of Bristol and University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom; School of Physiology, Pharmacology & Neuroscience, Biomedical Sciences, University of Bristol, Bristol, United Kingdom.
  4. School of Physiology, Pharmacology & Neuroscience, Biomedical Sciences, University of Bristol, Bristol, United Kingdom.
  5. NIHR Barts Cardiovascular Biomedical Research Unit, William Harvey Research Institute, QMUL, Charterhouse Square, London, United Kingdom.
  6. Department of Internal Medicine, Division of Cardiovascular Diseases, The Ohio State University, Columbus, Ohio.
  7. Neurosurgery, North Bristol NHS Trust, Southmead Hospital, Bristol, United Kingdom.
  8. Department of Physiology and Neurobiology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire.
  9. Cibiem, Los Altos, California.

PMID: 27766316 PMCID: PMC5063532 DOI: 10.1016/j.jacbts.2016.06.004

Abstract

Animal and human data indicate pathological afferent signaling emanating from the carotid body that drives sympathetically mediated elevations in blood pressure in conditions of hypertension. This first-in-man, proof-of-principle study tested the safety and feasibility of unilateral carotid body resection in 15 patients with drug-resistant hypertension. The procedure proved to be safe and feasible. Overall, no change in blood pressure was found. However, 8 patients showed significant reductions in ambulatory blood pressure coinciding with decreases in sympathetic activity. The carotid body may be a novel target for treating an identifiable subpopulation of humans with hypertension.

Keywords: ABP, ambulatory blood pressure; ASBP, ambulatory systolic blood pressure; BRS, baroreceptor reflex sensitivity; CB, carotid body; HRV, heart rate variability; HVR, hypoxic ventilatory response; MSNA, muscle sympathetic nerve activity; OBP, office blood pressure; OSBP, office systolic blood pressure; afferent drive; baroreceptor reflex; hypertension; hypoxia; peripheral chemoreceptor; sympathetic nervous system; uCB, unilateral carotid body

References

  1. J Physiol. 2000 May 15;525 Pt 1:143-58 - PubMed
  2. Lancet. 2005 Jan 15-21;365(9455):217-23 - PubMed
  3. Circulation. 2001 Jul 31;104(5):544-9 - PubMed
  4. J Physiol. 2011 Jan 1;589(Pt 1):245-58 - PubMed
  5. J Am Soc Hypertens. 2015 Jun;9(6):435-42 - PubMed
  6. J Appl Physiol (1985). 2001 Apr;90(4):1600-5 - PubMed
  7. Hypertension. 1988 Jun;11(6 Pt 2):608-12 - PubMed
  8. Dis Chest. 1961 Dec;40:595-604 - PubMed
  9. J Appl Physiol (1985). 2000 Feb;88(2):767-73 - PubMed
  10. Proc Natl Acad Sci U S A. 2014 Jan 21;111(3):1174-9 - PubMed
  11. Adv Exp Med Biol. 2009;648:223-33 - PubMed
  12. AJNR Am J Neuroradiol. 2011 Jun-Jul;32(6):1096-9 - PubMed
  13. Front Physiol. 2014 Aug 12;5:302 - PubMed
  14. Cardiovasc Res. 1982 Mar;16(3):163-72 - PubMed
  15. Hypertension. 2013 Sep;62(3):533-41 - PubMed
  16. Hypertens Res. 2014 Sep;37(9):858-62 - PubMed
  17. Front Physiol. 2015 Jan 14;5:524 - PubMed
  18. Hypertension. 2015 Jun;65(6):1266-72 - PubMed
  19. J Clin Sleep Med. 2012 Oct 15;8(5):597-619 - PubMed
  20. Hypertension. 2013 Jan;61(1):5-13 - PubMed
  21. Int Surg. 1972 Jun;57(6):458-66 - PubMed
  22. Adv Exp Med Biol. 1993;337:3-8 - PubMed
  23. Nat Commun. 2013;4:2395 - PubMed
  24. Circulation. 1996 Mar 1;93(5):1043-65 - PubMed
  25. J Appl Physiol (1985). 1988 Dec;65(6):2484-9 - PubMed
  26. Circulation. 1998 Mar 17;97(10):943-5 - PubMed
  27. Circulation. 2014 Jan 21;129(3):399-410 - PubMed
  28. Angiology. 2014 Jul;65(6):459-72 - PubMed
  29. J Hypertens. 2003 May;21(5):821-48 - PubMed
  30. Sleep Breath. 2014 Mar;18(1):103-9 - PubMed

Publication Types

Grant support