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ORIGINAL RESEARCH ARTICLE

Renal denervation guided by novel blood pressure response patterns of renal nerve stimulation in human: A case series study

Zhenhong Ou1,4 ,  Huaan Du1 ,  Weijie Chen1 ,  Hao Zhou1 ,  Hang Liu1 ,  Kun Cui4 ,  Bo Zhang1 ,  Dan Li1 ,  Tianli Xia1 ,  Huang Zhou1 ,  Yunlin Chen1 ,  Wenjiang Chen1 ,  Mingyang Xiao1 ,  Xue Kuang1 ,  Changzhi Zhang1 ,  Jie Yang1 ,  Chunxia Gan1 ,  Kamsang Woo2 ,  Zrenner Bernhard3 ,  Zengzhang Liu1 ,  Yuehui Yin1*
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1 Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing Cardiac Arrhythmia Therapeutic Service Center, Chongqing Key Laboratory of Arrhythmia, Chongqing, China
2 Institute of Future Cities, the Chinese University of Hong Kong, China
3 Department of Cardiology, Medizinische Klinik I, Krankenhaus Landshut/Achdorf, Germany
4 Department of Cardiology, Chongqing General Hospital, Chongqing, China
Brain & Heart 2023, 1(2), 0384 https://doi.org/10.36922/bh.0384
Submitted: 11 April 2023 | Accepted: 25 May 2023 | Published: 15 June 2023
© 2023 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Renal nerve stimulation (RNS) could localize the renal nerve innervation through rapid blood pressure (BP) changes for renal denervation (RDN). Recently, novel BP response patterns have been demonstrated in animals. The current study was to verify the presence of these patterns in humans and examine the feasibility of using them to guide selective RDN. Fourteen patients with mild resistant hypertension were included in this prospective analysis. RNS was performed before and after radiofrequency-based RDN. Invasive monitoring was used continuously to obtain beat-to-beat BP. Ambulatory BP (ABP) monitoring was measured at baseline, 5–7 days, and 6–12 months, respectively. Five types of BP responses were summarized during RNS before RDN, namely: (1) BP persistently elevated; (2) BP dropped and then elevated above the baseline; (3) BP dropped and then recovered, but not over the baseline; (4) BP fluctuated in the vicinity of the baseline; and (5) BP persistently dropped. Selective RDN was performed at the site with elevated BP. The 24-h ABP decreased from 141 ± 12/94 ± 9 mmHg at baseline to 130 ± 11/85 ± 8 mmHg at 5 – 7 days (P = 0.001 for systolic BP [SBP], P = 0.003 for diastolic BP [DBP]) and 127 ± 11/85 ± 8 mmHg at 6 – 12 months (P = 0.009 for SBP, P = 0.019 for DBP). The average heart rate fell from 77 ± 8 bpm to 71 ± 5 bpm (P = 0.01) and 72 ± 7 bpm (P = 0.043), respectively. Our study showed five types of BP responses elicited by RNS in humans. RDN guided by these BP responses was feasible and resulted in obvious BP reduction, and they may potentially provide precise guidance for RDN.

Keywords
Renal nerve stimulation
Renal denervation
Hypertension
Funding
Technology Star Cultivation Program from the Science and Technology Association of Chongqing
Surface project from the Chongqing Municipal Health Bureau
Kuanren Talents Program of the Second Affiliated Hospital of Chongqing Medical University
Conflict of interest
None.
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Brain & Heart, Electronic ISSN: 2972-4139 Published by AccScience Publishing
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