JACC: Basic to Translational Science (Aug 2016)
Unilateral Carotid Body Resection in Resistant Hypertension
- Krzysztof Narkiewicz, MD,
- Laura E.K. Ratcliffe, BSc, MBBS,
- Emma C. Hart, PhD,
- Linford J.B. Briant, PhD,
- Marzena Chrostowska, PhD,
- Jacek Wolf, MD,
- Anna Szyndler, MD,
- Dagmara Hering, MD,
- Ana P. Abdala, PhD,
- Nathan Manghat, MD,
- Amy E. Burchell, MA, BMBCh,
- Claire Durant, PhD,
- Melvin D. Lobo,
- Paul A. Sobotka, MD,
- Nikunj K. Patel, MBBS, MD,
- James C. Leiter, MD,
- Zoar J. Engelman, PhD,
- Angus K. Nightingale, MB, BChir, MD,
- Julian F.R. Paton, PhD
Affiliations
- Krzysztof Narkiewicz, MD
- Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland
- Laura E.K. Ratcliffe, BSc, MBBS
- CardioNomics Research Group, Clinical Research & Imaging Centre, University of Bristol and University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
- Emma C. Hart, PhD
- CardioNomics Research Group, Clinical Research & Imaging Centre, University of Bristol and University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
- Linford J.B. Briant, PhD
- CardioNomics Research Group, Clinical Research & Imaging Centre, University of Bristol and University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
- Marzena Chrostowska, PhD
- Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland
- Jacek Wolf, MD
- Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland
- Anna Szyndler, MD
- Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland
- Dagmara Hering, MD
- Department of Hypertension and Diabetology, Medical University of Gdansk, Gdansk, Poland
- Ana P. Abdala, PhD
- School of Physiology, Pharmacology & Neuroscience, Biomedical Sciences, University of Bristol, Bristol, United Kingdom
- Nathan Manghat, MD
- CardioNomics Research Group, Clinical Research & Imaging Centre, University of Bristol and University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
- Amy E. Burchell, MA, BMBCh
- CardioNomics Research Group, Clinical Research & Imaging Centre, University of Bristol and University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
- Claire Durant, PhD
- CardioNomics Research Group, Clinical Research & Imaging Centre, University of Bristol and University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
- Melvin D. Lobo
- NIHR Barts Cardiovascular Biomedical Research Unit, William Harvey Research Institute, QMUL, Charterhouse Square, London, United Kingdom
- Paul A. Sobotka, MD
- Department of Internal Medicine, Division of Cardiovascular Diseases, The Ohio State University, Columbus, Ohio
- Nikunj K. Patel, MBBS, MD
- Neurosurgery, North Bristol NHS Trust, Southmead Hospital, Bristol, United Kingdom
- James C. Leiter, MD
- Department of Physiology and Neurobiology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
- Zoar J. Engelman, PhD
- Cibiem, Los Altos, California
- Angus K. Nightingale, MB, BChir, MD
- CardioNomics Research Group, Clinical Research & Imaging Centre, University of Bristol and University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
- Julian F.R. Paton, PhD
- School of Physiology, Pharmacology & Neuroscience, Biomedical Sciences, University of Bristol, Bristol, United Kingdom
- DOI
- https://doi.org/10.1016/j.jacbts.2016.06.004
- Journal volume & issue
-
Vol. 1,
no. 5
pp. 313 – 324
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
- afferent drive
- baroreceptor reflex
- hypertension
- hypoxia
- peripheral chemoreceptor
- sympathetic nervous system
