Dae-Hee Kim

Jo HH, et al. Korean Circ J. 2027 ;57:e10. https://doi.org/10.4070/kcj.2025.0433

BACKGROUND: Catheter-based intravascular renal denervation produces modest, variable blood pressure reductions, partly because renal sympathetic nerves lie at variable depths within the periarterial adventitia and because accessory or early branching arteries are inaccessible to intraluminal catheters. We developed an extravascular renal denervation system (HyperQure) delivering circumferential radiofrequency energy from outside the artery and assessed its safety and efficacy. Here, we report the primary 3-month outcomes. METHODS: This prospective, multicenter, single-arm, first-in-human pilot trial enrolled 10 patients with resistant hypertension (office blood pressure ≥140/90 mm Hg and daytime ambulatory systolic blood pressure [SBP] ≥135 mm Hg despite ≥3 antihypertensive agents) across 7 Korean centers. All underwent bilateral extravascular renal denervation on stable antihypertensive regimens. The primary end point was 3-month change in 24-hour ambulatory SBP; safety outcomes were assessed through 3 months. RESULTS: All 10 patients (median age, 52.5 years; 7 men) completed follow-up. Seven patients (70%) had accessory or early branching arteries P =0.008) and median office SBP by 39.5 mm Hg ( P =0.002). Seven of 10 (70%) achieved office SBP <140 mm Hg despite a reduction in median antihypertensive burden from 6.0 to 4.5 agents. No major or procedure-related adverse events occurred; follow-up computed tomography angiography showed no vascular complications and renal function was preserved. CONCLUSIONS: Extravascular renal denervation using the HyperQure renal denervation System warrants evaluation in a larger controlled trial, particularly in patients with complex renal arterial anatomy.

Background: Postoperative progression of tricuspid regurgitation (TR) is an adverse consequence after pericardiectomy in patients with constrictive pericarditis (CP). We aimed to identify predictors, as well as the clinical significance, of TR development following pericardiectomy in CP patients. Methods: A total of 132 CP patients with mild or less TR before pericardiectomy, performed between March 1991 and March 2023, were enrolled. Patients were divided into two groups based on TR severity on pre-discharge echocardiography. Patients who maintained mild or less TR were assigned into the No-TR group, whereas those who showed significant (moderate or greater) TR were assigned into the TR group. The primary endpoint was all-cause death. Results: Among the 132 patients, 110 patients (83.3%) were classified into the No-TR group, and 22 patients (16.7%) into the TR group. The median follow-up period was 4.65 years. A low body surface area, presence of diabetes mellitus, large mitral valve (MV) annulus diameter, and left atrial volume index (LAVI) were predictors of significant TR after pericardiectomy. The optimal cutoff values for MV annulus diameter and LAVI were 30.51 mm and 31.65 mL/m², respectively. All-cause mortality was significantly higher in the TR group than in the No-TR group (hazard ratio 2.26; 95% confidence interval 1.09–4.70; log-rank p=0.018). Conclusion: An enlarged left atrium is a risk factor for postoperative significant TR resulting in poor survival after pericardiectomy in CP patients. These results may help to identify patients who may benefit from combined tricuspid valve surgery.

Introduction Despite needing intensive blood pressure (BP) control, elderly patients with hypertension may be undertreated because of concern about potential hypotension-related adverse events (AEs). Many older patients need combination therapy to achieve BP targets. This study investigated whether single-pill combination (SPC) antihypertensive therapy may benefit such patients. Methods This study analyzed pooled data from patients treated with olmesartan/amlodipine/hydrochlorothiazide (O/A/H) SPC therapy in three multicenter, prospective, observational studies (RESOLVE, RESOLVE-PRO and RESOLVE-INT) in South Korea. The primary endpoint was the incidence of hypotension-related AEs (hypotension/orthostatic hypotension, dizziness/postural dizziness, syncope, falls/fractures), stratified by age: < 65 years (non-elderly), 65‒79 years (elderly), and ≥ 80 years (very elderly). Secondary endpoints included hypotension-related AEs stratified by O/A/H dose and by baseline systolic BP (SBP) and diastolic BP (DBP), and SBP change from baseline to Week 24, and at Weeks 8, 16 and 24, stratified by age. Results From 16,646 pooled participants, 10,948 met the inclusion criteria and received ≥ 1 dose of O/A/H (safety set): 5892 were < 65 years old, 4143 were 65–79, and 911 were aged ≥ 80 years (two had missing age data). The effectiveness set comprised 9292 with complete BP data. Hypotension-related AEs occurred in 4.82% (95% CI 4.29, 5.40) of non-elderly patients, 4.44% (95% CI 3.83, 5.11) of elderly patients, and 4.61% (95% CI 3.34, 6.18) of the very elderly group, with no statistically significant difference in relative risk between age groups. There was no difference in relative risk of hypotension-related AEs with increased O/A/H dosage in patients aged > 65 years and stratified by baseline SBP or DBP. All groups achieved effective BP reductions, with mean BP < 140/90 mmHg at 24 weeks. Conclusion The O/A/H single-pill combination is well tolerated and effective in elderly and very elderly Korean patients with hypertension, offering a safe and practical therapeutic option for achieving BP control in the aging hypertensive population. Trial Registration Clinical Research Information Service—Republic of Korea, KCT0010343 (https://cris.nih.go.kr/cris/search/detailSearch.do?seq=29557&search_page=L).

Lee EM, et al. Clin Hypertens. 2026 ;32:e31. https://doi.org/10.5646/ch.2026.32.e31

Park S, et al. Korean Circ J. 2026 Jan;56:e43. https://doi.org/10.4070/kcj.2025.0211