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. 2023 Apr;33(2):93-100.
doi: 10.1007/s10286-023-00927-z. Epub 2023 Jan 25.

Differential effects of renal denervation on skin and muscle sympathetic nerve traffic in resistant and uncontrolled hypertension

Raffaella Dell'Oro  1 , Fosca Quarti-Trevano  1 , Gino Seravalle  1   2 , Cesare Cuspidi  1 , Guido Grassi  3
Affiliations

Differential effects of renal denervation on skin and muscle sympathetic nerve traffic in resistant and uncontrolled hypertension

Raffaella Dell'Oro et al. Clin Auton Res. 2023 Apr.

Abstract

Purpose: Renal denervation (RDN) exerts sympathoinhibitory effects. No information is available, however, on whether these effects have a regional or a more generalized behavior.

Methods: In 14 patients with resistant hypertension (RHT, age 58.3 ± 2.2 years, mean ± SEM), we recorded muscle and skin sympathetic nerve traffic (MSNA and SSNA, respectively) using the microneurographic technique, before, 1 month, and 3 months after RDN. Measurements included clinic blood pressure (BP), heart rate (HR), 24-h BP and HR, as well as routine laboratory and echocardiographic variables. Ten age-matched RHT patients who did not undergo RDN served as controls.

Results: MSNA, but not SSNA, was markedly higher in RHT. RDN caused a significant reduction in MSNA 1 month after RDN, with this reduction increasing after 3 months (from 68.1 ± 2.5 to 64.8 ± 2.4 and 63.1 ± 2.6 bursts/100 heartbeats, P < 0.05). This effect was not accompanied by any significant change in SSNA (from 13.1 ± 0.5 to 13.4 ± 0.6 and 13.3 ± 0.4 bursts/min, P = NS). No quantitative or, in some cases, qualitative relationship was found between BP and the MSNA reduction induced by RDN. No significant changes in various sympathetic markers were detected in the control group who did not undergo RDN and were followed for 3-months observation.

Conclusions: These data provide the first evidence that RDN exerts heterogeneous effects on sympathetic cardiovascular drive, inducing a marked reduction in MSNA but not in SSNA, which appears to be within the normal range in this condition.These effects may depend on the different reflex modulation regulating neuroadrenergic drive in these cardiovascular districts.

Keywords: Blood pressure; Heart rate; Renal denervation; Resistant hypertension; Sympathetic nervous system.

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Conflict of interest statement

The Authors report no relationship that could be considered as a conflict of interest.

Figures

Fig. 1
Fig. 1
Effects of renal denervation on office blood pressure (BP), 24-h BP, office heart rate (HR), and 24-h HR values in resistant hypertensive patients. Data are represented before (baseline) and 1 and 3 months after the procedure. Data are shown as individual and average values (mean ± SEM) in each condition. Asterisks (*P < 0.05) refer to the statistical significance between baseline values and values recorded at different times after renal denervation
Fig. 2
Fig. 2
Effects of renal denervation on muscle sympathetic nerve traffic (MSNA, left panel) and skin sympathetic nerve traffic (SSNA, right panel) in resistant hypertensive patients. Data are shown before (baseline) and 1 and 3 months after the procedure. Data are shown as individual and average values (mean ± SEM) in each condition. Asterisks (*) refer to the statistical significance (P < 0.05) between baseline values and values recorded at different times after renal denervation
See this image and copyright information in PMC

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