Renal nerve stimulation identifies renal innervation and optimizes the strategy for renal denervation in canine.
Blood pressure
Renal autonomic innervation
Renal denervation
Renal nerve stimulation
Journal
Journal of translational medicine
ISSN: 1479-5876
Titre abrégé: J Transl Med
Pays: England
ID NLM: 101190741
Informations de publication
Date de publication:
09 02 2023
09 02 2023
Historique:
received:
10
06
2022
accepted:
25
01
2023
entrez:
10
2
2023
pubmed:
11
2
2023
medline:
14
2
2023
Statut:
epublish
Résumé
Renal denervation (RDN) was still performed without any intra-procedural method for nerve mapping. Whether renal nerve stimulation (RNS) is an efficient way to identify renal autonomic innervation and optimize the strategy for RDN remain to be worthy for further exploration. The characteristics of renal autonomic innervation at the sites with different blood pressure (BP) responses to RNS were explored. Then, dogs anatomically eligible for RDN were randomly assigned into elevated BP response ablation group, reduced BP response ablation group, and RNS-control group. The postoperative outcomes were measured at baseline and after 4 weeks follow-up. The proportion of afferent sensory nerve was higher at elevated BP response sites (ERS) than reduced BP response sites (RRS) and non-response sites (NRS) (P = 0.012 and P = 0.004). Conversely, the proportion of parasympathetic nerve at RRS was the highest (RRS vs. ERS, P = 0.017; RRS vs. NRS, P = 0.023). More importantly, there was a significant correlation between systolic blood pressure changes and the area ratios of afferent sensory and parasympathetic nerve (R = 0.859; P < 0.001). In addition, ablation at BP-elevation sites can result in a significant decrease in BP and plasma norepinephrine (NE) after 4 weeks (P = 0.002; P = 0.008), while ablation at BP-reduction sites can lead to significant increases in BP and plasma NE (P = 0.016; P = 0.033). RNS is an effective method to identify renal autonomic innervation. It could not only help to identify optimal target sites, but also avoid ablation of sympathetic-inhibitory areas during RDN.
Sections du résumé
BACKGROUND
Renal denervation (RDN) was still performed without any intra-procedural method for nerve mapping. Whether renal nerve stimulation (RNS) is an efficient way to identify renal autonomic innervation and optimize the strategy for RDN remain to be worthy for further exploration.
METHODS
The characteristics of renal autonomic innervation at the sites with different blood pressure (BP) responses to RNS were explored. Then, dogs anatomically eligible for RDN were randomly assigned into elevated BP response ablation group, reduced BP response ablation group, and RNS-control group. The postoperative outcomes were measured at baseline and after 4 weeks follow-up.
RESULTS
The proportion of afferent sensory nerve was higher at elevated BP response sites (ERS) than reduced BP response sites (RRS) and non-response sites (NRS) (P = 0.012 and P = 0.004). Conversely, the proportion of parasympathetic nerve at RRS was the highest (RRS vs. ERS, P = 0.017; RRS vs. NRS, P = 0.023). More importantly, there was a significant correlation between systolic blood pressure changes and the area ratios of afferent sensory and parasympathetic nerve (R = 0.859; P < 0.001). In addition, ablation at BP-elevation sites can result in a significant decrease in BP and plasma norepinephrine (NE) after 4 weeks (P = 0.002; P = 0.008), while ablation at BP-reduction sites can lead to significant increases in BP and plasma NE (P = 0.016; P = 0.033).
CONCLUSIONS
RNS is an effective method to identify renal autonomic innervation. It could not only help to identify optimal target sites, but also avoid ablation of sympathetic-inhibitory areas during RDN.
Identifiants
pubmed: 36759871
doi: 10.1186/s12967-023-03919-9
pii: 10.1186/s12967-023-03919-9
pmc: PMC9912587
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
100Informations de copyright
© 2023. The Author(s).
Références
Lancet. 2017 Nov 11;390(10108):2160-2170
pubmed: 28859944
Am J Physiol Regul Integr Comp Physiol. 2015 Jan 15;308(2):R79-95
pubmed: 25411364
J Hum Hypertens. 2019 Oct;33(10):716-724
pubmed: 31477828
Compr Physiol. 2017 Mar 16;7(2):263-320
pubmed: 28333375
Int J Cardiol. 2014 Dec 15;177(2):669-71
pubmed: 25449478
J Cardiovasc Transl Res. 2022 Feb;15(1):29-37
pubmed: 34282540
Hypertension. 2013 Feb;61(2):450-6
pubmed: 23283361
Lancet. 2009 Apr 11;373(9671):1275-81
pubmed: 19332353
Int J Cardiol. 2015;190:296-8
pubmed: 25932812
Lancet. 2010 Dec 4;376(9756):1903-9
pubmed: 21093036
J Am Coll Cardiol. 2019 Jun 18;73(23):3006-3017
pubmed: 31196459
Interv Cardiol. 2019 May 21;14(2):102-106
pubmed: 31178937
J Hypertens. 2020 Aug;38(8):1488-1495
pubmed: 32195820
Lancet. 2022 Apr 9;399(10333):1401-1410
pubmed: 35390320
Lancet. 2018 Jun 9;391(10137):2335-2345
pubmed: 29803590
Int J Physiol Pathophysiol Pharmacol. 2018 Mar 10;10(1):17-28
pubmed: 29593847
Circulation. 2019 Jan 29;139(5):590-600
pubmed: 30586691
Lancet. 2020 May 2;395(10234):1444-1451
pubmed: 32234534
Am J Physiol Regul Integr Comp Physiol. 2016 Feb 1;310(3):R262-7
pubmed: 26661098
Circulation. 2012 Dec 18;126(25):2976-82
pubmed: 23248063
J Am Heart Assoc. 2017 Aug 10;6(8):
pubmed: 28862930
Blood Press. 2018 Oct;27(5):271-279
pubmed: 29653494
Int J Cardiol. 2019 Jul 1;286:66-72
pubmed: 30777408
Circ Cardiovasc Interv. 2015 Jun;8(6):
pubmed: 26058393
Front Physiol. 2020 Jan 31;10:1625
pubmed: 32082182
Hypertension. 2019 Sep;74(3):536-545
pubmed: 31327262
Hypertension. 2016 Sep;68(3):707-14
pubmed: 27432864
Ann Anat. 2016 Mar;204:71-9
pubmed: 26617159
Am J Hypertens. 2015 Jul;28(7):909-14
pubmed: 25576624
N Engl J Med. 2014 Apr 10;370(15):1393-401
pubmed: 24678939
J Hypertens. 2020 Apr;38(4):765-773
pubmed: 31764582
Lancet. 2018 Jun 9;391(10137):2346-2355
pubmed: 29803589
Future Cardiol. 2020 Jul;16(4):211-216
pubmed: 32166965
Curr Hypertens Rep. 2018 May 1;20(5):37
pubmed: 29717380
Prog Cardiovasc Dis. 2020 Jan - Feb;63(1):51-57
pubmed: 31884099
Eur Heart J. 2014 Jul;35(26):1752-9
pubmed: 24898552
Clin Res Cardiol. 2018 Dec;107(12):1131-1138
pubmed: 29845330
J Hum Hypertens. 2015 May;29(5):292-5
pubmed: 25339295
Hypertension. 2016 Dec;68(6):1415-1423
pubmed: 27698066
J Craniofac Surg. 2020 May/Jun;31(3):865-870
pubmed: 31842081
J Am Coll Cardiol. 2014 Aug 19;64(7):635-43
pubmed: 25125292
Clin Anat. 2016 Jul;29(5):660-4
pubmed: 27090982
J Am Soc Hypertens. 2016 May;10(5):457-66
pubmed: 27052349
Int J Cardiol. 2017 Aug 15;241:373-378
pubmed: 28465113