Sympathetic Vasomotion Reflects Catheter-Based Radiofrequency Renal Denervation
Year: 2025
Type: article
Abstract: BACKGROUND: The field of renal denervation remains challenged by the inability to confirm successful ablation of the targeted renal sympathetic nerves. The availability of technology to measure regional blood flow in real-time makes sympathetic control of the renal vasculature a logical end point to assess effective renal denervation, but autoregulatory mechanisms mask effects on mean renal blood flow. We hypothesized that renal sympathetic vasomotion, a novel marker of rhythmic sympathetic control, reflects successive rounds of catheter-based radiofrequency renal denervation. METHODS: To test this, 10 pigs underwent unilateral surgical renal denervation, recovered for at least 7 days, and then underwent 4 successive rounds of catheter-based radiofrequency denervation of the contralateral kidney. Bilateral renal blood flow velocity and abdominal aortic pressure were measured before and after ablations to calculate renal vasomotion. RESULTS: <0.005). Ablation of the largest renal branch artery reduced renal sympathetic vasomotion by 52%. Ablation of the remaining renal branch arteries reduced sympathetic vasomotion by 95% from baseline and eliminated the statistical differences between surgically and catheter-denervated kidneys. Two additional rounds of catheter denervation of the main renal artery did not consistently decrease the renal sympathetic vasomotion magnitude any further. CONCLUSIONS: These results indicate that renal sympathetic vasomotion could provide intraprocedural feedback for interventionalists performing catheter-based renal denervation and thereby improve the efficacy, safety, and consistency of this antihypertensive intervention.
Source: Hypertension
Institutions: University of Nebraska Medical Center, University of Miami
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: green
Awards: G2848018020, G3340291065, G5398814827, Novel Neural Mechanisms underlying Lung-Heart Pathological Crosstalk, Novel Stellate Ganglia Chemo-ablation Approach to Treat Cardiac Arrhythmia and Cardiac Remodeling in Heart Failure, Neural Inflammation and Exercise Pressor Reflex in Heart Failure, Nrf2 and the exaggerated Exercise Pressor Reflex in Peripheral Arterial Disease
OpenAlex ID: W4410786135