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Treatment of resistant arterial hypertension: pharmacological and interventional aproach


Author: Moiseeva Anna
Degree:doctor of medicine
Speciality: 14.00.06 - Cardiology and Reumatology
Year:2021
Scientific adviser: Alexandru Carauş
doctor habilitat, professor
Scientific consultant: Ion Popovici
doctor habilitat, professor
Institution: Medical-Sanitary Public Institution Institute of Cardiology

Status

The thesis was presented on the 16 September, 2021
Approved by NCAA on the 26 November, 2021

Abstract

Adobe PDF document – 0.99 Mb / in romanian

Thesis

CZU 616.12-008.331.1-085

Adobe PDF document 3.40 Mb / in romanian
187 pages

Keywords

renal artery denervation, resistant hypertension, diastolic dysfunction, sympathetic nervous system, ablation of renal arteries

Summary

This thesis consists of introduction, six chapters, conclusions, practical recommendations, bibliography with 236 of sources. The paper is exposed on 149 pages of basic text. Illustrative material includes 78 tables and 31 figures. The research results are published in 37 scientific articles.

Aim of the study: To evaluate the influence of renal artery denervation versus drug treatment on BP values, diastolic function, and LV myocardial remodeling indices in patients with treatment-resistant essential hypertension.

Research objectives: To estimate the effect of renal denervation versus pharmacological treatment on blood pressure values, variability and diurnal BP profile, benefit on diastolic function and LV myocardial remodeling indices in treatment-resistant hypertension. Evaluation of the evolution of the NTpro-BNP fragment and physical capacity according to the applied medication. Incidence of adverse effects: pharmacological versus suplimented with renal denervation.

Scientific novelty and originality: The research conducted for the first time in the Republic of Moldova evaluated the comparative efficacy of minimally invasive treatment by renal arteries denervation and pharmacological treatment with SNS blockers in patients with resistant hypertension.

Scientific problem solved: Confirmation of the effectiveness of both pharmacological and interventional treatment in reducing blood pressure, improving diastolic function and the degree of heart failure in patients with resistant hypertension.

Theoretical significance: The results obtained have a high theoretical impact in supplementing the data from the literature on the efficacy and safety of renal denervation in patients with resistant hypertension.

Applied value: The research will facilitate the approach of patients with resistant hypertension.

Implementation of scientific results: The results of the study were implemented in the curative activity of Institute of Cardiology, Novamed Hospital, Municipal Clinical Hospital " Sfânta Treime " and in the academic process at the State Medical and Pharmaceutical University "Nicolae Testemitanu".