title: Blood pressure response to renal nerve stimulation in patients undergoing renal denervation: a feasibility study.
abstract: During renal sympathetic denervation (RDN), no mapping of renal nerves is performed and there is no clear end point of RDN. We hypothesized high-frequency renal nerve stimulation (RNS) may increase blood pressure (BP), and this increase is significantly blunted after RDN. The aim of this study was to determine the feasibility of RNS in patients undergoing RDN. Eight patients with resistant hypertension undergoing RDN were included. A quadripolar catheter was positioned at four different sites in either renal artery. RNS was performed during 1 min with a pacing frequency of 20 Hz. After all patients successfully underwent RDN, RNS was repeated at the site of maximum BP response before RDN in either renal artery. Mean age was 66 years. During RNS, BP increased significantly from 108/55 to 132/68 mm Hg (P < 0.001). After RDN, systolic BP response at the site of maximum response to RNS was significantly blunted (+43.1 vs +9.3 mm Hg, P = 0.002). In three patients, a systolic BP increase >10 mm Hg was observed after RDN. In conclusion, RNS resulted in an acute temporary BP increase. This response was significantly blunted after RDN. RNS may potentially serve as an end point for RDN.
authors.affiliation: Department of Cardiology, Isala Klinieken, Zwolle, The Netherlands.
authors.forename: P
authors.initials: P
authors.lastname: Gal
authors.affiliation: Department of Cardiology, Isala Klinieken, Zwolle, The Netherlands.
authors.forename: M R
authors.initials: MR
authors.lastname: de Jong
authors.affiliation: Department of Cardiology, Isala Klinieken, Zwolle, The Netherlands.
authors.forename: J J J
authors.initials: JJ
authors.lastname: Smit
authors.affiliation: Department of Cardiology, Isala Klinieken, Zwolle, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Adiyaman
authors.affiliation: The Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Leuven, Belgium.
authors.forename: J A
authors.initials: JA
authors.lastname: Staessen
authors.affiliation: Department of Cardiology, Isala Klinieken, Zwolle, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Elvan
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000502:physiology; D001795:Blood Pressure Determination; D002406:Catheterization, Peripheral / Q000379:methods; D004351:Drug Resistance; D004558:Electric Stimulation / Q000379:methods*; D057510:Endovascular Procedures / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007668:Kidney / Q000098:blood supply / Q000294:innervation; D008297:Male; D008875:Middle Aged; D012077:Renal Artery; D013562:Sympathectomy / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D007004:Hypoglycemic Agents