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. 2020 Sep 15:8:e9842.
doi: 10.7717/peerj.9842. eCollection 2020.

Effects of different ablation points of renal denervation on the efficacy of resistant hypertension

Hua Zhang #  1 , Ling-Yan Li #  1 , Rong-Xue Xiao  2 , Ting-Chuan Zhang  1 , Zong-Jun Liu  2 , Jun-Qing Gao  1
Affiliations

Effects of different ablation points of renal denervation on the efficacy of resistant hypertension

Hua Zhang et al. PeerJ. .

Abstract

Objective: To explore the blood pressure response to different ablation points of renal denervation (RDN) in patients with resistant hypertension.

Methods: A total of 42 cases with resistant hypertension treated by RDN in our center from 2013 to 2015 were retrospectively analyzed. The patients were divided into two groups according to the different ablation points of RDN: the standard treatment group (spiral ablation from near to proximal, with less than 8 points per artery) and the intensive treatment group (from near to far by spiral ablation, with at least 8 points per artery), with 21 patients in each group. The ablation parameters, including points, impedance, actual wattage, and actual temperature, were recorded intraoperatively. Renal angiography was performed again after RDN. Ambulatory blood pressure (ABP) images were taken for all patients at the baseline and 6 months after operation.

Results: The mean 24-h blood pressure of the standard treatment group was lower than that of the baseline (24-h systolic blood pressure decreased by 7.4 ± 10.6 mmHg and 24-h diastolic blood pressure decreased by 4.6 ± 6.1 mmHg), and the mean 24-h blood pressure decreased significantly from baseline to 6 months in the intensive treatment group (24-h systolic blood pressure decreased by 27.4 ± 11.4 mmHg, P < 0.0001; 24-h diastolic blood pressure decreased by 10.9 ± 9.6 mmHg, P = 0.005). There was a positive correlation between the decrease of systolic/diastolic 24-hour mean and the number of ablation points used in the procedure. The mean value of systolic and diastolic blood pressure was positively correlated with ablation points at 24-hour (R 2 = 0.777 and 0.633 respectively, P < 0.01). There were no adverse events in either group after the operation and during the follow-up.

Conclusions: RDN could significantly reduce BP in patients with resistant hypertension. Our study showed that the antihypertensive effect appeared to be positively correlated with the number of ablation points.

Keywords: Ablation points; Resistant hypertension.

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Conflict of interest statement

The authors declare there are no competing interests.

Figures

Figure 1
Figure 1. (A) The standard treatment group: spiral ablation from near to proximal, with less than 8 points per artery; (B) the intensive treatment group: from near to far by spiral ablation, with at least 8 points per artery.
Figure 2
Figure 2. Change of systolic and diastolic 24-h AMBP 6 months after renal denervation.
(A) shows no significant difference in baseline BP before ablation; (B) shows no significant difference in 6 months postoperative BP; (C) shows the dynamic SBP and DBP in patients received intensive treatment were significantly lower compared to patients in the standard treatment group.
Figure 3
Figure 3. Correlation between the number of ablation points and mean changes of SBP and DBP after 6 months were analyzed.
(A) The results of 24-hour ABPM showed that the average SBP decline rate increased with the number of ablation points; (B) the results of 24-hour ABPM showed that the average DBP decline rate increased with the number of ablation points, but slightly lower than that of SBP.
See this image and copyright information in PMC

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