In:
Brain & Heart, AccScience Publishing, Vol. 1, No. 1 ( 2023-06-15), p. 0384-
Kurzfassung:
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.
Materialart:
Online-Ressource
ISSN:
2972-4139
Sprache:
Unbekannt
Verlag:
AccScience Publishing
Publikationsdatum:
2023
