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29.05.2018 | Original Paper

Changes in arterial pressure hemodynamics in response to renal nerve stimulation both before and after renal denervation

verfasst von: Annemiek F. Hoogerwaard, Ahmet Adiyaman, Mark R. de Jong, Jaap Jan J. Smit, Peter Paul H. M. Delnoy, Jan-Evert Heeg, Boudewijn A. A. M. van Hasselt, Anand R. Ramdat Misier, Michiel Rienstra, Arif Elvan

Erschienen in: Clinical Research in Cardiology | Ausgabe 12/2018

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Abstract

Background

Renal nerve denervation (RDN) is developed as a potential treatment for hypertension. Recently, we reported the use of renal nerve stimulation (RNS) to localize sympathetic nerve tissue for subsequent selective RDN. The effects of RNS on arterial pressure dynamics remain unknown. The current study aimed to describe the acute changes in arterial pressure dynamics response to RNS before and after RDN.

Methods and results

Twenty six patients with drug-resistant hypertension referred for RDN were included. RNS was performed under general anesthesia before and after RDN. We continuously monitored heart rate (HR) and invasive femoral blood pressure (BP). Augmentation pressure (AP) and index (Aix), pulse pressure (PP), time to reflected wave, maximum systolic BP and dicrotic notch were calculated. Systolic and diastolic BP at site of maximum response significantly increased in response to RNS (120 ± 16/62 ± 9 to 150 ± 22/75 ± 15 mmHg) (p < 0.001/< 0.001), whereas after RDN no RNS-induced BP change was observed (p > 0.10). RNS increased Aix (29 ± 11 to 32 ± 13%, p = 0.005), PP (59 ± 14 to 75 ± 17 mmHg, p < 0.001), time to reflected wave (63 ± 18 to 71 ± 25 ms, p = 0.004) and time to maximum systolic pressure (167 ± 36 to 181 ± 46 ms, p = 0.004) before RDN, whereas no changes were observed after RDN (p > 0.18). All changes were BP dependent. RNS had no influence on HR or the time to dicrotic notch (p > 0.12).

Conclusion

RNS induces temporary rises in Aix, PP, time to maximum systolic pressure and time to reflected wave. These changes are BP dependent and were completely blunted after RDN.

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Titel: Changes in arterial pressure hemodynamics in response to renal nerve stimulation both before and after renal denervation
verfasst von: Annemiek F. Hoogerwaard
Ahmet Adiyaman
Mark R. de Jong
Jaap Jan J. Smit
Peter Paul H. M. Delnoy
Jan-Evert Heeg
Boudewijn A. A. M. van Hasselt
Anand R. Ramdat Misier
Michiel Rienstra
Arif Elvan
Publikationsdatum: 29.05.2018
Verlag: Springer Berlin Heidelberg
Erschienen in: Clinical Research in Cardiology / Ausgabe 12/2018
Print ISSN: 1861-0684
Elektronische ISSN: 1861-0692
DOI: https://doi.org/10.1007/s00392-018-1287-2

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Changes in arterial pressure hemodynamics in response to renal nerve stimulation both before and after renal denervation