title: Selective proximal renal denervation guided by autonomic responses evoked via high-frequency stimulation in a preclinical canine model.
abstract: BACKGROUND
  Electric stimulation has been proved to be available to monitor the efficacy of renal denervation (RDN). This study was to evaluate the effectiveness of high-frequency stimulation (HFS)-guided proximal RDN.
  
  
  RESULTS
  A total of 13 Chinese Kunming dogs were included and allocated to proximal RDN group (n=8) and control group (n=5). HFS (20 Hz, 8 V, pulse width 2 ms) was performed from proximal to distal renal artery in all dogs. Radiofrequency ablations were delivered in proximal RDN group and only at the proximal positive sites where systolic blood pressure (BP) increased ≥10 mm Hg during HFS. Postablation HFS was performed over the previously stimulated sites. BP, heart rate, and plasma norepinephrine were analyzed. In 8 denervated dogs, preablation HFS caused significant BP increases of 6.0±5.0/3.4±5.5, 16.9±11.7/11.1±8.5, and 17.1±8.4/8.5±5.3 mm Hg during the first, second, and third 20 s of HFS at the proximal positive sites. After ablation, these sites showed a negative response to postablation HFS with increases of BP by 1.3±3.0/1.0±2.5, 0.8±3.9/1.5±3.4, and 1.5±4.5/0.7±3.8 mm Hg. Of note, no radiofrequency applications were delivered at the positive sites of middle renal artery, repeated HFS increased BP only by 3.3±5.3/2.8±4.2, 5.3±6.6/3.8±4.7, and 2.9±4.6/1.3±3.2 mm Hg, failed to reproduce the previous BP increases of 6.2±5.6/5.3±4.4, 15.0±9.3/10.2±6.2, and 14.9±7.7/8.4±4.7 mm Hg. At 3 months, BP and plasma norepinephrine substantially decreased in proximal RDN group. Whereas controls showed minimal BP decreases and had similar plasma norepinephrine concentrations as baseline.
  
  
  CONCLUSIONS
  Renal afferent nerves can be mapped safely, and HFS-guided targeted proximal RDN can achieve apparent BP reduction and sympathetic inhibition.
authors.affiliation: From the Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing Cardiac Arrhythmias Therapeutic Service Center, Chongqing, China (J.L., Z.W., T.Z., S.C., W.C., H.D., Z.T., H.Y., X.H., C.L., Z.L., Z.L., Y.Y.); Medizinische Klinik I, Krankenhaus Landshut/Achdorf, Landshut, Germany (B.Z.); and School of Life Sciences, the Chinese University of Hong Kong, Hong Kong, China (K.W.).
authors.forename: Jiayi
authors.initials: J
authors.lastname: Lu
authors.affiliation: From the Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing Cardiac Arrhythmias Therapeutic Service Center, Chongqing, China (J.L., Z.W., T.Z., S.C., W.C., H.D., Z.T., H.Y., X.H., C.L., Z.L., Z.L., Y.Y.); Medizinische Klinik I, Krankenhaus Landshut/Achdorf, Landshut, Germany (B.Z.); and School of Life Sciences, the Chinese University of Hong Kong, Hong Kong, China (K.W.).
authors.forename: Zhenglong
authors.initials: Z
authors.lastname: Wang
authors.affiliation: From the Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing Cardiac Arrhythmias Therapeutic Service Center, Chongqing, China (J.L., Z.W., T.Z., S.C., W.C., H.D., Z.T., H.Y., X.H., C.L., Z.L., Z.L., Y.Y.); Medizinische Klinik I, Krankenhaus Landshut/Achdorf, Landshut, Germany (B.Z.); and School of Life Sciences, the Chinese University of Hong Kong, Hong Kong, China (K.W.).
authors.forename: Tingquan
authors.initials: T
authors.lastname: Zhou
authors.affiliation: From the Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing Cardiac Arrhythmias Therapeutic Service Center, Chongqing, China (J.L., Z.W., T.Z., S.C., W.C., H.D., Z.T., H.Y., X.H., C.L., Z.L., Z.L., Y.Y.); Medizinische Klinik I, Krankenhaus Landshut/Achdorf, Landshut, Germany (B.Z.); and School of Life Sciences, the Chinese University of Hong Kong, Hong Kong, China (K.W.).
authors.forename: Shaojie
authors.initials: S
authors.lastname: Chen
authors.affiliation: From the Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing Cardiac Arrhythmias Therapeutic Service Center, Chongqing, China (J.L., Z.W., T.Z., S.C., W.C., H.D., Z.T., H.Y., X.H., C.L., Z.L., Z.L., Y.Y.); Medizinische Klinik I, Krankenhaus Landshut/Achdorf, Landshut, Germany (B.Z.); and School of Life Sciences, the Chinese University of Hong Kong, Hong Kong, China (K.W.).
authors.forename: Weijie
authors.initials: W
authors.lastname: Chen
authors.affiliation: From the Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing Cardiac Arrhythmias Therapeutic Service Center, Chongqing, China (J.L., Z.W., T.Z., S.C., W.C., H.D., Z.T., H.Y., X.H., C.L., Z.L., Z.L., Y.Y.); Medizinische Klinik I, Krankenhaus Landshut/Achdorf, Landshut, Germany (B.Z.); and School of Life Sciences, the Chinese University of Hong Kong, Hong Kong, China (K.W.).
authors.forename: Huaan
authors.initials: H
authors.lastname: Du
authors.affiliation: From the Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing Cardiac Arrhythmias Therapeutic Service Center, Chongqing, China (J.L., Z.W., T.Z., S.C., W.C., H.D., Z.T., H.Y., X.H., C.L., Z.L., Z.L., Y.Y.); Medizinische Klinik I, Krankenhaus Landshut/Achdorf, Landshut, Germany (B.Z.); and School of Life Sciences, the Chinese University of Hong Kong, Hong Kong, China (K.W.).
authors.forename: Zhen
authors.initials: Z
authors.lastname: Tan
authors.affiliation: From the Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing Cardiac Arrhythmias Therapeutic Service Center, Chongqing, China (J.L., Z.W., T.Z., S.C., W.C., H.D., Z.T., H.Y., X.H., C.L., Z.L., Z.L., Y.Y.); Medizinische Klinik I, Krankenhaus Landshut/Achdorf, Landshut, Germany (B.Z.); and School of Life Sciences, the Chinese University of Hong Kong, Hong Kong, China (K.W.).
authors.forename: Hanxuan
authors.initials: H
authors.lastname: Yang
authors.affiliation: From the Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing Cardiac Arrhythmias Therapeutic Service Center, Chongqing, China (J.L., Z.W., T.Z., S.C., W.C., H.D., Z.T., H.Y., X.H., C.L., Z.L., Z.L., Y.Y.); Medizinische Klinik I, Krankenhaus Landshut/Achdorf, Landshut, Germany (B.Z.); and School of Life Sciences, the Chinese University of Hong Kong, Hong Kong, China (K.W.).
authors.forename: Xinyu
authors.initials: X
authors.lastname: Hu
authors.affiliation: From the Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing Cardiac Arrhythmias Therapeutic Service Center, Chongqing, China (J.L., Z.W., T.Z., S.C., W.C., H.D., Z.T., H.Y., X.H., C.L., Z.L., Z.L., Y.Y.); Medizinische Klinik I, Krankenhaus Landshut/Achdorf, Landshut, Germany (B.Z.); and School of Life Sciences, the Chinese University of Hong Kong, Hong Kong, China (K.W.).
authors.forename: Chang
authors.initials: C
authors.lastname: Liu
authors.affiliation: From the Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing Cardiac Arrhythmias Therapeutic Service Center, Chongqing, China (J.L., Z.W., T.Z., S.C., W.C., H.D., Z.T., H.Y., X.H., C.L., Z.L., Z.L., Y.Y.); Medizinische Klinik I, Krankenhaus Landshut/Achdorf, Landshut, Germany (B.Z.); and School of Life Sciences, the Chinese University of Hong Kong, Hong Kong, China (K.W.).
authors.forename: Zhiyu
authors.initials: Z
authors.lastname: Ling
authors.affiliation: From the Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing Cardiac Arrhythmias Therapeutic Service Center, Chongqing, China (J.L., Z.W., T.Z., S.C., W.C., H.D., Z.T., H.Y., X.H., C.L., Z.L., Z.L., Y.Y.); Medizinische Klinik I, Krankenhaus Landshut/Achdorf, Landshut, Germany (B.Z.); and School of Life Sciences, the Chinese University of Hong Kong, Hong Kong, China (K.W.).
authors.forename: Zengzhang
authors.initials: Z
authors.lastname: Liu
authors.affiliation: From the Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing Cardiac Arrhythmias Therapeutic Service Center, Chongqing, China (J.L., Z.W., T.Z., S.C., W.C., H.D., Z.T., H.Y., X.H., C.L., Z.L., Z.L., Y.Y.); Medizinische Klinik I, Krankenhaus Landshut/Achdorf, Landshut, Germany (B.Z.); and School of Life Sciences, the Chinese University of Hong Kong, Hong Kong, China (K.W.).
authors.forename: Bernhard
authors.initials: B
authors.lastname: Zrenner
authors.affiliation: From the Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing Cardiac Arrhythmias Therapeutic Service Center, Chongqing, China (J.L., Z.W., T.Z., S.C., W.C., H.D., Z.T., H.Y., X.H., C.L., Z.L., Z.L., Y.Y.); Medizinische Klinik I, Krankenhaus Landshut/Achdorf, Landshut, Germany (B.Z.); and School of Life Sciences, the Chinese University of Hong Kong, Hong Kong, China (K.W.).
authors.forename: Kamsang
authors.initials: K
authors.lastname: Woo
authors.affiliation: From the Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing Cardiac Arrhythmias Therapeutic Service Center, Chongqing, China (J.L., Z.W., T.Z., S.C., W.C., H.D., Z.T., H.Y., X.H., C.L., Z.L., Z.L., Y.Y.); Medizinische Klinik I, Krankenhaus Landshut/Achdorf, Landshut, Germany (B.Z.); and School of Life Sciences, the Chinese University of Hong Kong, Hong Kong, China (K.W.). yinyh63@163.com.
authors.forename: Yuehui
authors.initials: Y
authors.lastname: Yin
mesh_terms: D000344:Afferent Pathways / Q000502:physiology; D000818:Animals; D001794:Blood Pressure; D017115:Catheter Ablation; D004285:Dogs; D004558:Electric Stimulation; D006973:Hypertension / Q000601:surgery*; D064795:Intraoperative Neurophysiological Monitoring; D007668:Kidney / Q000294:innervation*; D023421:Models, Animal; D009638:Norepinephrine / Q000097:blood; D012077:Renal Artery / Q000601:surgery; D013562:Sympathectomy / Q000379:methods*
chemical_list: D009638:Norepinephrine
keywords: blood pressure; catheter ablation; heart rate; hypertension; renal artery