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- Title
Catheter-Based Radiofrequency Renal Denervation: Location Effects on Renal Norepinephrine.
- Authors
Henegar, Jeffrey R.; Yongxing Zhang; Hata, Cary; Narciso, Irvin; Hall, Michael E.; Hall, John E.
- Abstract
BACKGROUND Clinical studies indicate that blood pressure (BP)-lowering effects of radiofrequency (RF) renal denervation (RD) are sustained for up to 2 years, although a recent clinical trial failed tofind a major effect compared to sham treatment. In most previous studies, the efficacy of RD has not been assessed. The current study determined whether RD in different regions of the renal artery causes different degrees of RD as assessed with renal norepinephrine (NE) levels. METHODS AND RESULTS Unilateral RD was performed on 14 pigs divided into 3 groups: RD near the ostium, in the main renal artery near the bifurcation, and in extrarenal branches of the renal artery. After 2 weeks post-RD, the pigs were euthanized, renal cortex tissue was collected for NE measurement, and renal arteries were prepared for histological analysis. Renal NE decreased by 12% with RD at the ostium, 45% with RD near the bifurcation in the main renal artery, and 74% when RD was performed in extrarenal artery branches. The number of renal nerves was greatest in extrarenal branches and in the main artery compared to the ostium and the average distance from the lumen was greatest for nerves at the ostium and least at the branches. CONCLUSIONS RF RD lowers renal NE more significantly when performed in branches of the renal artery closer to the kidney. Increased efficacy of RF RD in extrarenal arterial branches may be due to the greater number of nerves in close proximity to the artery lumen in the branches.
- Subjects
CATHETER ablation; NORADRENALINE regulation; NORADRENALINE; DENERVATION; BIFURCATION theory; RENAL artery; BLOOD pressure
- Publication
American Journal of Hypertension, 2015, Vol 28, Issue 7, p909
- ISSN
0895-7061
- Publication type
Article
- DOI
10.1093/ajh/hpu258