Abstract
Autonomic nervous system plays a crucial role in maintaining and regulating vessel tension. Renal denervation (RDN) may induce renal artery vasodilation by damaging renal sympathetic fibers. We conducted this animal study to evaluate whether renal artery vasodilation could be a direct indicator of successful RDN. Twenty-eight Chinese Kunming dogs were randomly assigned into three groups and underwent RDN utilizing temperature-controlled catheter (group A, n = 11) or saline-irrigated catheter (group B, n = 11) or sham procedure (group C, n = 6). Renal angiography, blood pressure (BP) and renal artery vasodilation measurements were performed at baseline, 30-minute, 1-month, and 3-month after interventions. Plasma norepinephrine concentrations were tested at baseline and 3-month after intervention. Results showed that, in addition to significant BP reduction, RDN induced significant renal artery vasodilation. Correlation analyses showed that the induced renal artery vasodilation positively correlated with SBP reduction and plasma norepinephrine reduction over 3 months after ablation. Post hoc analyses showed that saline-irrigated catheter was superior to TC catheter in renal artery vasodilation, especially for the acute dilatation of renal artery at 30-minute after RDN. In conclusion, renal artery vasodilation, induced by RDN, may be a possible indicator of successful renal nerve damage and a predictor of blood pressure response to RDN.
Highlights
A series of clinical studies[7,8,9,10,11] indicated that Renal denervation (RDN) could lead to significant blood pressure (BP) reduction in patients with resistant hypertension until to the Simplicity HTN-312 failed to demonstrate the superiority of RDN over pharmacological management of hypertension no matter for office BP or 24-hour ambulatory BP measurements
On the basis of the above mentioned, we hypothesize that once renal sympathetic fibers are damaged or sufficiently injured by catheter based RDN, in addition to BP reduction, renal artery vasodilation would be observed immediately
Thirty Chinese Kunming dogs were randomly assigned in a 2:2:1 ratio to group A undergoing RDN with TC catheter (n = 12) or group B undergoing RDN with saline-irrigated catheter (n = 12) or group C undergoing a sham procedure (n = 6)
Summary
A series of clinical studies[7,8,9,10,11] indicated that RDN could lead to significant blood pressure (BP) reduction in patients with resistant hypertension until to the Simplicity HTN-312 failed to demonstrate the superiority of RDN over pharmacological management of hypertension no matter for office BP or 24-hour ambulatory BP measurements. On the basis of the above mentioned, we hypothesize that once renal sympathetic fibers are damaged or sufficiently injured by catheter based RDN, in addition to BP reduction, renal artery vasodilation would be observed immediately. Templin showed that local tissue damage significantly decreased mean diameter of renal artery after RDN performed with the temperature-controlled (TC) radiofrequency (RF) EnligHTN catheter or the Symplicity catheter[24]. The aim of this study was to investigate the impact of RDN on renal artery vasodilation and BP reduction via saline-irrigated and temperature-controlled radiofrequency catheters
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