Page 43 - BH-1-2

Brain & Heart

ORIGINAL RESEARCH ARTICLE
Renal denervation guided by novel blood

pressure response patterns of renal nerve
stimulation in human: A case series study

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Zhenhong Ou , Huaan Du , Weijie Chen , Hao Zhou , Hang Liu , Kun Cui ,
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Bo Zhang , Dan Li , Tianli Xia , Huang Zhou , Yunlin Chen , Wenjiang Chen ,
Mingyang Xiao , Xue Kuang , Changzhi Zhang , Jie Yang , Chunxia Gan ,
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Kamsang Woo , Zrenner Bernhard , Zengzhang Liu , and Yuehui Yin *
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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
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
*Corresponding author:
Yuehui Yin radiofrequency-based RDN. Invasive monitoring was used continuously to obtain
(yinyh@hospital.cqmu.edu.cn) 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
Citation: Ou Z, Du H, Chen W,
et al., 2023, Renal denervation during RNS before RDN, namely: (1) BP persistently elevated; (2) BP dropped and
guided by novel blood pressure then elevated above the baseline; (3) BP dropped and then recovered, but not over
response patterns of renal nerve the baseline; (4) BP fluctuated in the vicinity of the baseline; and (5) BP persistently
stimulation in human: A case series
study. Brain & Heart, 1(2): 0384. dropped. Selective RDN was performed at the site with elevated BP. The 24-h ABP
https://doi.org/10.36922/bh.0384 decreased from 141 ± 12/94 ± 9 mmHg at baseline to 130 ± 11/85 ± 8 mmHg at
Received: April 11, 2023 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
Accepted: May 25, 2023
heart rate fell from 77 ± 8 bpm to 71 ± 5 bpm (P = 0.01) and 72 ± 7 bpm (P = 0.043),
Published Online: June 15, 2023 respectively. Our study showed five types of BP responses elicited by RNS in humans.
Copyright: © 2023 Author(s). RDN guided by these BP responses was feasible and resulted in obvious BP reduction,
This is an Open Access article and they may potentially provide precise guidance for RDN.
distributed under the terms of the
Creative Commons Attribution
License, permitting distribution, Keywords: Renal nerve stimulation; Renal denervation; Hypertension
and reproduction in any medium,
provided the original work is
properly cited.
Publisher’s Note: AccScience
Publishing remains neutral with 1. Introduction
regard to jurisdictional claims in
published maps and institutional Catheter-based renal denervation (RDN) destroys nerves around the adventitia of the
affiliations. renal artery using radiofrequency, ultrasound, or other energy to cause a reduction of
Volume 1 Issue 2 (2023) 1 https://doi.org/10.36922/bh.0384