title: Renal Nerve Stimulation-Induced Blood Pressure Changes Predict Ambulatory Blood Pressure Response After Renal Denervation.
abstract: Blood pressure (BP) response to renal denervation (RDN) is highly variable and its effectiveness debated. A procedural end point for RDN may improve consistency of response. The objective of the current analysis was to look for the association between renal nerve stimulation (RNS)-induced BP increase before and after RDN and changes in ambulatory BP monitoring (ABPM) after RDN. Fourteen patients with drug-resistant hypertension referred for RDN were included. RNS was performed under general anesthesia at 4 sites in the right and left renal arteries, both before and immediately after RDN. RNS-induced BP changes were monitored and correlated to changes in ambulatory BP at a follow-up of 3 to 6 months after RDN. RNS resulted in a systolic BP increase of 50±27 mm Hg before RDN and systolic BP increase of 13±16 mm Hg after RDN (P<0.001). Average systolic ABPM was 153±11 mm Hg before RDN and decreased to 137±10 mm Hg at 3- to 6-month follow-up (P=0.003). Changes in RNS-induced BP increase before versus immediately after RDN and changes in ABPM before versus 3 to 6 months after RDN were correlated, both for systolic BP (R=0.77, P=0.001) and diastolic BP (R=0.79, P=0.001). RNS-induced maximum BP increase before RDN had a correlation of R=0.61 (P=0.020) for systolic and R=0.71 (P=0.004) for diastolic ABPM changes. RNS-induced BP changes before versus after RDN were correlated with changes in 24-hour ABPM 3 to 6 months after RDN. RNS should be tested as an acute end point to assess the efficacy of RDN and predict BP response to RDN.
authors.affiliation: From the Departments of Cardiology, Internal Medicine, and Radiology, Isala Hospital, Zwolle, The Netherlands (M.R.d.J., A.A., P.G., J.J.J.S., P.P.H.M.D., J.-E.H., B.A.A.M.v.H., A.R.R.M., A.E.); Center for Innovation and Strategic Collaboration, St Jude Medical, Inc, Irvine, CA (E.O.Y.L.); Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium (A.P.); Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium (A.P.); The Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (J.A.S.); and University of Rochester School of Medicine & Dentistry, Arrhythmia Institute of The Valley Health System, New York and Ridgewood, NJ (J.S.S.).
authors.forename: Mark R
authors.initials: MR
authors.lastname: de Jong
authors.affiliation: From the Departments of Cardiology, Internal Medicine, and Radiology, Isala Hospital, Zwolle, The Netherlands (M.R.d.J., A.A., P.G., J.J.J.S., P.P.H.M.D., J.-E.H., B.A.A.M.v.H., A.R.R.M., A.E.); Center for Innovation and Strategic Collaboration, St Jude Medical, Inc, Irvine, CA (E.O.Y.L.); Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium (A.P.); Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium (A.P.); The Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (J.A.S.); and University of Rochester School of Medicine & Dentistry, Arrhythmia Institute of The Valley Health System, New York and Ridgewood, NJ (J.S.S.).
authors.forename: Ahmet
authors.initials: A
authors.lastname: Adiyaman
authors.affiliation: From the Departments of Cardiology, Internal Medicine, and Radiology, Isala Hospital, Zwolle, The Netherlands (M.R.d.J., A.A., P.G., J.J.J.S., P.P.H.M.D., J.-E.H., B.A.A.M.v.H., A.R.R.M., A.E.); Center for Innovation and Strategic Collaboration, St Jude Medical, Inc, Irvine, CA (E.O.Y.L.); Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium (A.P.); Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium (A.P.); The Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (J.A.S.); and University of Rochester School of Medicine & Dentistry, Arrhythmia Institute of The Valley Health System, New York and Ridgewood, NJ (J.S.S.).
authors.forename: Pim
authors.initials: P
authors.lastname: Gal
authors.affiliation: From the Departments of Cardiology, Internal Medicine, and Radiology, Isala Hospital, Zwolle, The Netherlands (M.R.d.J., A.A., P.G., J.J.J.S., P.P.H.M.D., J.-E.H., B.A.A.M.v.H., A.R.R.M., A.E.); Center for Innovation and Strategic Collaboration, St Jude Medical, Inc, Irvine, CA (E.O.Y.L.); Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium (A.P.); Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium (A.P.); The Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (J.A.S.); and University of Rochester School of Medicine & Dentistry, Arrhythmia Institute of The Valley Health System, New York and Ridgewood, NJ (J.S.S.).
authors.forename: Jaap Jan J
authors.initials: JJ
authors.lastname: Smit
authors.affiliation: From the Departments of Cardiology, Internal Medicine, and Radiology, Isala Hospital, Zwolle, The Netherlands (M.R.d.J., A.A., P.G., J.J.J.S., P.P.H.M.D., J.-E.H., B.A.A.M.v.H., A.R.R.M., A.E.); Center for Innovation and Strategic Collaboration, St Jude Medical, Inc, Irvine, CA (E.O.Y.L.); Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium (A.P.); Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium (A.P.); The Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (J.A.S.); and University of Rochester School of Medicine & Dentistry, Arrhythmia Institute of The Valley Health System, New York and Ridgewood, NJ (J.S.S.).
authors.forename: Peter Paul H M
authors.initials: PP
authors.lastname: Delnoy
authors.affiliation: From the Departments of Cardiology, Internal Medicine, and Radiology, Isala Hospital, Zwolle, The Netherlands (M.R.d.J., A.A., P.G., J.J.J.S., P.P.H.M.D., J.-E.H., B.A.A.M.v.H., A.R.R.M., A.E.); Center for Innovation and Strategic Collaboration, St Jude Medical, Inc, Irvine, CA (E.O.Y.L.); Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium (A.P.); Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium (A.P.); The Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (J.A.S.); and University of Rochester School of Medicine & Dentistry, Arrhythmia Institute of The Valley Health System, New York and Ridgewood, NJ (J.S.S.).
authors.forename: Jan-Evert
authors.initials: JE
authors.lastname: Heeg
authors.affiliation: From the Departments of Cardiology, Internal Medicine, and Radiology, Isala Hospital, Zwolle, The Netherlands (M.R.d.J., A.A., P.G., J.J.J.S., P.P.H.M.D., J.-E.H., B.A.A.M.v.H., A.R.R.M., A.E.); Center for Innovation and Strategic Collaboration, St Jude Medical, Inc, Irvine, CA (E.O.Y.L.); Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium (A.P.); Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium (A.P.); The Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (J.A.S.); and University of Rochester School of Medicine & Dentistry, Arrhythmia Institute of The Valley Health System, New York and Ridgewood, NJ (J.S.S.).
authors.forename: Boudewijn A A M
authors.initials: BA
authors.lastname: van Hasselt
authors.affiliation: From the Departments of Cardiology, Internal Medicine, and Radiology, Isala Hospital, Zwolle, The Netherlands (M.R.d.J., A.A., P.G., J.J.J.S., P.P.H.M.D., J.-E.H., B.A.A.M.v.H., A.R.R.M., A.E.); Center for Innovation and Strategic Collaboration, St Jude Medical, Inc, Irvine, CA (E.O.Y.L.); Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium (A.P.); Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium (A.P.); The Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (J.A.S.); and University of Rochester School of Medicine & Dentistry, Arrhythmia Institute of The Valley Health System, New York and Ridgewood, NJ (J.S.S.).
authors.forename: Elizabeth O Y
authors.initials: EO
authors.lastname: Lau
authors.affiliation: From the Departments of Cardiology, Internal Medicine, and Radiology, Isala Hospital, Zwolle, The Netherlands (M.R.d.J., A.A., P.G., J.J.J.S., P.P.H.M.D., J.-E.H., B.A.A.M.v.H., A.R.R.M., A.E.); Center for Innovation and Strategic Collaboration, St Jude Medical, Inc, Irvine, CA (E.O.Y.L.); Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium (A.P.); Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium (A.P.); The Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (J.A.S.); and University of Rochester School of Medicine & Dentistry, Arrhythmia Institute of The Valley Health System, New York and Ridgewood, NJ (J.S.S.).
authors.forename: Alexandre
authors.initials: A
authors.lastname: Persu
authors.affiliation: From the Departments of Cardiology, Internal Medicine, and Radiology, Isala Hospital, Zwolle, The Netherlands (M.R.d.J., A.A., P.G., J.J.J.S., P.P.H.M.D., J.-E.H., B.A.A.M.v.H., A.R.R.M., A.E.); Center for Innovation and Strategic Collaboration, St Jude Medical, Inc, Irvine, CA (E.O.Y.L.); Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium (A.P.); Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium (A.P.); The Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (J.A.S.); and University of Rochester School of Medicine & Dentistry, Arrhythmia Institute of The Valley Health System, New York and Ridgewood, NJ (J.S.S.).
authors.forename: Jan A
authors.initials: JA
authors.lastname: Staessen
authors.affiliation: From the Departments of Cardiology, Internal Medicine, and Radiology, Isala Hospital, Zwolle, The Netherlands (M.R.d.J., A.A., P.G., J.J.J.S., P.P.H.M.D., J.-E.H., B.A.A.M.v.H., A.R.R.M., A.E.); Center for Innovation and Strategic Collaboration, St Jude Medical, Inc, Irvine, CA (E.O.Y.L.); Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium (A.P.); Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium (A.P.); The Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (J.A.S.); and University of Rochester School of Medicine & Dentistry, Arrhythmia Institute of The Valley Health System, New York and Ridgewood, NJ (J.S.S.).
authors.forename: Anand R
authors.initials: AR
authors.lastname: Ramdat Misier
authors.affiliation: From the Departments of Cardiology, Internal Medicine, and Radiology, Isala Hospital, Zwolle, The Netherlands (M.R.d.J., A.A., P.G., J.J.J.S., P.P.H.M.D., J.-E.H., B.A.A.M.v.H., A.R.R.M., A.E.); Center for Innovation and Strategic Collaboration, St Jude Medical, Inc, Irvine, CA (E.O.Y.L.); Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium (A.P.); Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium (A.P.); The Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (J.A.S.); and University of Rochester School of Medicine & Dentistry, Arrhythmia Institute of The Valley Health System, New York and Ridgewood, NJ (J.S.S.).
authors.forename: Jonathan S
authors.initials: JS
authors.lastname: Steinberg
authors.affiliation: From the Departments of Cardiology, Internal Medicine, and Radiology, Isala Hospital, Zwolle, The Netherlands (M.R.d.J., A.A., P.G., J.J.J.S., P.P.H.M.D., J.-E.H., B.A.A.M.v.H., A.R.R.M., A.E.); Center for Innovation and Strategic Collaboration, St Jude Medical, Inc, Irvine, CA (E.O.Y.L.); Pole of Cardiovascular Research, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium (A.P.); Division of Cardiology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium (A.P.); The Studies Coordinating Centre, Research Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, University of Leuven, Belgium (J.A.S.); and University of Rochester School of Medicine & Dentistry, Arrhythmia Institute of The Valley Health System, New York and Ridgewood, NJ (J.S.S.). v.r.c.derks@isala.nl.
authors.forename: Arif
authors.initials: A
authors.lastname: Elvan
mesh_terms: D000328:Adult; D000368:Aged; D017763:Autonomic Denervation / Q000379:methods*; D018660:Blood Pressure Monitoring, Ambulatory; D017115:Catheter Ablation / Q000379:methods; D004558:Electric Stimulation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012077:Renal Artery / Q000294:innervation* / Q000601:surgery*; D018570:Risk Assessment; D012494:Sampling Studies; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
keywords: 24-hour ABPM; drug-resistant hypertension; renal denervation; renal nerve stimulation