Transvascular Pacing of Aorticorenal Ganglia Provides a Testable Procedural Endpoint for Renal Artery Denervation

Qian, Pierre; Barry, Michael A.; Lu, Juntang; Pouliopoulos, Jim; Mina, Ashraf; Bandodkar, Sushil; Alvarez, Shirley; James, Virginia; Ronquillo, John; Varikatt, Winny; Thiagalingam, Aravinda; Thomas, Stuart P.

doi:10.1016/j.jcin.2019.04.047

Cited by 20 publications

(18 citation statements)

References 21 publications

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“…Doltra et al [61] and Chen et al [62] demonstrated that renal artery vasodilation was observed after intervention in human and canine, and Chen further revealed that vasodilation was correlated with blood pressure reduction and plasma norepinephrine at 3-month follow-up. On the other hand, it is reported that transvascular pacing of aorticorenal ganglion in sheep produced ipsilateral renal arterial vasoconstriction without contralateral renal vasoconstriction [63], which might also provide a predictive indicator for successful RDN and procedural endpoint if vasoconstriction effect vanishes. ey believed that aorticorenal ganglion pacing may elicit the hypertensive effect by afferents and the renal vasoconstrictive effect by efferent nerves.…”

Section: Renal Artery Vasodilationmentioning

confidence: 99%

Present Evidence of Determinants to Predict the Efficacy of Renal Denervation

Zhou

Chen

et al. 2022

International Journal of Hypertension

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Sympathetic overactivation is one of the main contributors to development and progress of hypertension. Renal denervation (RDN) has been evidenced by series of clinical trials for its efficacy and safety to treat overactivated sympathetic nervous system induced diseases. However, the results were inconsistent and not all patients benefited from RDN. Appropriate patient selection and intraoperative factors to improve the efficacy of RDN need to be solved urgently. Over the decade, research studies on the correlations between indicators and the antihypertensive effects have been conducted and made a fairly well progress. Herein, we comprehensively reviewed the research studies on how to make RDN more predictable or improve the efficacy of RDN and summarized these potential indicators or devices which might be applied in clinical settings.

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Section: Renal Artery Vasodilationmentioning

confidence: 99%

Present Evidence of Determinants to Predict the Efficacy of Renal Denervation

Zhou

Chen

et al. 2022

International Journal of Hypertension

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“…They suggested that abolition of ARG pacing‐induced renal arterial vasoconstriction may serve as a physiological endpoint for RDN. 35 …”

Section: Renal Nerve Stimulation Studiesmentioning

confidence: 99%

The role of renal nerve stimulation in percutaneous renal denervation for hypertension: A mini‐review

Huang

Cheng

Chia

et al. 2022

J of Clinical Hypertension

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Recent trials have demonstrated the efficacy and safety of percutaneous renal sympathetic denervation (RDN) for blood pressure (BP)-lowering in patients with uncontrolled hypertension. Nevertheless, major challenges exist, such as the wide variation of BP-lowering responses following RDN (from strong response to no response) and lack of feasible and reproducible peri-procedural predictors for patient response. Both animal and human studies have demonstrated different patterns of BP responsesfollowing renal nerve stimulation (RNS), possibly related to varied regional proportions of sympathetic and parasympathetic nerve tissues along the renal arteries. Animal studies of RNS have shown that rapid electrical stimulation of the renal arteries causedThis is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.

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“…The disappearance of these responses could be an endpoint for denervation procedures. [73] An alternative method to potentially identify adequate efferent nerve destruction via sympathetically-mediated renovascular vasomotion has also been reported recently. [74] Observable changes in low frequency power spectral components derived from real time renal arterial pressure and flow waveforms following sympathetic blockade were reported in both normotensive rabbit and porcine pre-clinical models.…”

Section: Procedural Endpointsmentioning

confidence: 99%

Device-Based Treatment in Hypertension: At the Forefront of Renal Denervation

Kario

Hettrick

Esler

2021

Cardiology Discovery

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Percutaneous renal denervation is a novel device therapy that modifies the circulatory regulatory system and has received considerable attention recently. This treatment partially blocks the renal sympathetic nervous system, which is an organ-connecting pathway between the brain and the kidney. Denervation techniques currently under clinical investigation include radiofrequency, ultrasonic, and chemical ablation with alcohol, all of which are executed through transcatheter access to the renal artery. All recently published randomized sham-controlled trials have shown a clear antihypertensive effect of renal denervation over 24 hours, including during the nighttime and early morning. This treatment has promise in the management of poorly controlled hypertension as well as in the prevention of the development or aggravation of arrhythmias and heart failure.

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Transvascular Pacing of Aorticorenal Ganglia Provides a Testable Procedural Endpoint for Renal Artery Denervation

Cited by 20 publications

References 21 publications

Present Evidence of Determinants to Predict the Efficacy of Renal Denervation

Present Evidence of Determinants to Predict the Efficacy of Renal Denervation

The role of renal nerve stimulation in percutaneous renal denervation for hypertension: A mini‐review

Device-Based Treatment in Hypertension: At the Forefront of Renal Denervation

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