Sympathetic Vasomotion Reflects Catheter-Based Radiofrequency Renal Denervation.

IF 6.9 1区 医学 Q1 PERIPHERAL VASCULAR DISEASE
Peter Ricci Pellegrino, Irving H Zucker, Yiannis S Chatzizisis, Han-Jun Wang, Alicia M Schiller
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引用次数: 0

Abstract

Background: The field of renal denervation remains challenged by the inability to confirm successful ablation of the targeted renal sympathetic nerves. The availability of technology to measure regional blood flow in real-time makes sympathetic control of the renal vasculature a logical end point to assess effective renal denervation, but autoregulatory mechanisms mask effects on mean renal blood flow. We hypothesized that renal sympathetic vasomotion, a novel marker of rhythmic sympathetic control, reflects successive rounds of catheter-based radiofrequency renal denervation.

Methods: To test this, 10 pigs underwent unilateral surgical renal denervation, recovered for at least 7 days, and then underwent 4 successive rounds of catheter-based radiofrequency denervation of the contralateral kidney. Bilateral renal blood flow velocity and abdominal aortic pressure were measured before and after ablations to calculate renal vasomotion.

Results: Before catheter-based denervation, the renal vasomotion profiles of the innervated and surgically denervated kidneys differed significantly (P<0.005). Ablation of the largest renal branch artery reduced renal sympathetic vasomotion by 52%. Ablation of the remaining renal branch arteries reduced sympathetic vasomotion by 95% from baseline and eliminated the statistical differences between surgically and catheter-denervated kidneys. Two additional rounds of catheter denervation of the main renal artery did not consistently decrease the renal sympathetic vasomotion magnitude any further.

Conclusions: These results indicate that renal sympathetic vasomotion could provide intraprocedural feedback for interventionalists performing catheter-based renal denervation and thereby improve the efficacy, safety, and consistency of this antihypertensive intervention.

交感血管舒缩反映导管射频肾去神经。
背景:肾去神经领域仍然是挑战,无法确认成功消融的目标肾交感神经。实时测量局部血流量的技术的可用性使得对肾脏血管的交感控制成为评估有效的肾去神经支配的逻辑终点,但自身调节机制掩盖了对平均肾血流量的影响。我们假设肾脏交感血管运动,一种新的有节奏的交感控制标志,反映了连续几轮基于导管的射频肾去神经支配。方法:为了验证这一点,10头猪接受了单侧手术肾去神经,恢复至少7天,然后进行了连续4轮基于导管的对侧肾射频去神经。消融前后分别测量双侧肾血流速度和腹主动脉压,计算肾脏血管舒缩。结果:导管去神经前,神经支配肾和手术去神经肾的血管舒缩特征有显著差异(p)。结论:肾交感血管舒缩可为介入医师进行导管去神经干预提供术中反馈,从而提高该降压干预的有效性、安全性和一致性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Hypertension
Hypertension 医学-外周血管病
CiteScore
15.90
自引率
4.80%
发文量
1006
审稿时长
1 months
期刊介绍: Hypertension presents top-tier articles on high blood pressure in each monthly release. These articles delve into basic science, clinical treatment, and prevention of hypertension and associated cardiovascular, metabolic, and renal conditions. Renowned for their lasting significance, these papers contribute to advancing our understanding and management of hypertension-related issues.
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