Search

BACKGROUND: Resistant hypertension is a common clinical problem of blood pressure that is not controlled despite the simultaneous application of multiple antihypertensive agents. Ablation of renal afferent nerves has been applied and proved to decrease hypertension and injuries produced by severe sympathetic hyperactivity. The main objective of this study was to investigate the long-term effect of renal artery sympathetic ablation and its complications in patients with treatment-resistant hypertension. METHODS: In this prospective study which done between March 2012 and November 2013, 30 patients with resistant arterial hypertension despite treatment with ≥3 antihypertensive drugs-were randomly enrolled in this self-control clinical study in Isfahan, Iran. The patients were treated with the renal denervation procedure; the femoral artery was accessed with the standard endovascular technique and the Symplicity catheter was advanced into the renal artery and connected to a radiofrequency generator. Before and 12 months after renal denervation procedure waist, body mass index (BMI), systolic blood pressure (SBP), diastolic blood pressure (DBP), metabolic syndrome, fasting blood sugar (FBS), high-density lipoprotein (HDL), and triglyceride were measured in all patients. RESULTS: Both mean SBP and DBP were significantly decreased, 12 months after renal denervation (P < 0.001). The frequency of metabolic syndrome was not significantly different after renal denervation in compare to baseline (P = 0.174). Furthermore, a significant decreased in FBS and triglyceride was observed in compare to baseline (P = 0.001). CONCLUSION: This study highlighted the role of renal sympathetic denervation as a modern and secure catheter-based method for sustained reduction hypertension in treatment-resistant cases.

Background: Myocardial Infarction is a common and lethal disease, especially in first hours. Rapid and correct decision is essential for priority of advance therapies and this study follows the accuracy of a scoring system for this triage. The aim was to assess the correlation of Thrombolysis in Myocardial Infarction Risk score and Angio score in patients with ST Elevation Myocardial Infarction. Methods: In this cross sectional study, 240 patients with ST elevation myocardial infarction from CCU of universal hospitals participated in the study. Thrombolysis in myocardial infarction risk score was calculated and during 2 month they underwent angiography and follow up. Findings: Mean age was 60.02 and 79 patients were female. Correlation between thrombolysis in myocardial infarction risk and angio score was significant (P < 0.001). Correlation between ejection fraction and thrombolysis in myocardial infarction risk score (P < 0.001) and angio score with age (P < 0.001) was significant too. There was no significant correlation between Angio score and recurrent angina (P = 0.143), rehospitalization (P = 0.524) and death (P = 0.179). Pearson's correlation showed significant relation between thrombolysis in myocardial infarction risk score and angio score (P < 0.001, r = 0.556). Conclusion: This correlation shows that thrombolysis in myocardial infarction risk score probably can be used for evaluating angiographic extent of coronary artery disease. Simple clinical use of this score at bedside if confirms with a prospective cohort study, makes this score a method to stratify patients in high and low risk groups and accordingly diagnostic– therapeutic strategies. Key words:Thrombolysis in myocardial infarction risk score, Angio score, ST elevation myocardial infarction, Ejection fraction.