title: Impact of local vascular lesions assessed with optical coherence tomography and ablation points on blood pressure reduction after renal denervation.
abstract: Local vascular injury is detectable with optical coherence tomography (OCT) after catheter-based renal denervation (RDN). However, it is unclear whether the number and type of vascular lesions or the number of ablation points could affect blood pressure (BP) reduction. The aim of the study was to assess the impact of vascular injury induced by RDN detected with OCT and the number of ablation points on BP response after 1, 3 and 6 months.
  
  
  METHODS
  RDN was either performed with a Simplicity catheter or an EnligHTNTM multielectrode basket followed by OCT. BP was recorded prospectively as office measurement and 24-hour ambulatory blood pressure monitoring (24-h ABPM) at each time point. Correlations between type and number of vascular lesions, as well as ablation points, on BP reduction were performed.
  
  
  RESULTS
  Out of 16 patients, two were lost to BP follow-up. We documented a BP reduction at 1, 3 and 6 months in both office and 24-h ABPM. The Δmean office systolic BP (SBP) reduction was -18.75 ± 24.55 mm Hg, -20.58 ± 16.92 mm Hg and -18.75 ± 29.39 mm Hg, respectively, and the Δmean 24h-ABPM SBP reduction was -6.50 ± 23.45 mm Hg, -16.88 ± 26.64 mm Hg and -13.89 ± 21.20 mm Hg, respectively. The number of vascular lesions did not correlate with office and 24h-SBP and diastolic BP reduction. However, there was a correlation between ablation points and office Δmean SBP reduction at 6 months (p <0.02).
  
  
  CONCLUSIONS
  Our study demonstrates for the first time that the number and type of vascular lesions as assessed with OCT did not predict the success of BP reduction after RDN. However, we observed a substantial decrease in office SBP in relation to the number of ablation points at 6 months.
authors: University Heart Centre, Department of Cardiology, University Hospital Zurich, Switzerland.
authors: Jelena-Rima
authors: JR
authors: Ghadri
authors: University Heart Centre, Department of Cardiology, University Hospital Zurich, Switzerland.
authors: Roman
authors: R
authors: Gaehwiler
authors: University Heart Centre, Department of Cardiology, University Hospital Zurich, Switzerland.
authors: Milosz
authors: M
authors: Jaguszewski
authors: University Heart Centre, Department of Cardiology, University Hospital Zurich, Switzerland.
authors: Isabella
authors: I
authors: Sudano
authors: University Heart Centre, Department of Cardiology, University Hospital Zurich, Switzerland.
authors: Julia
authors: J
authors: Osipova
authors: St Anna Klinik, Luzern, Switzerland.
authors: Renate
authors: R
authors: Schoenenberger-Berzins
authors: University Heart Centre, Department of Cardiology, University Hospital Zurich, Switzerland.
authors: Paul
authors: P
authors: Erne
authors: University Heart Centre, Department of Cardiology, University Hospital Zurich, Switzerland.
authors: Thomas F
authors: TF
authors: Lüscher
authors: University Heart Centre, Department of Cardiology, University Hospital Zurich, Switzerland.
authors: Christian
authors: C
authors: Templin
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D018660:Blood Pressure Monitoring, Ambulatory / Q000379:methods; D017115:Catheter Ablation; D005260:Female; D006801:Humans; D006973:Hypertension / Q000601:surgery*; D007668:Kidney / Q000294:innervation*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis*; D011446:Prospective Studies; D012077:Renal Artery / Q000293:injuries*; D013562:Sympathectomy / Q000379:methods*; D041623:Tomography, Optical Coherence; D016896:Treatment Outcome; D057772:Vascular System Injuries / Q000175:diagnosis*