Renal Sympathetic Denervation: An Effective Non-Pharmacological Treatment Strategy for Sympathetic Over-Activation Related Diseases

The renal sympathetic nerve is a main target in cardiovascular diseases, because of the special relationship between the heart and kidney. Therefore, many drugs that inhibit the neuroendocrine system, such as angiotensin converting enzyme inhibitors/angiotensin receptor blocker (ACEI/ARB), beta blockers, and aldosterone inhibitors, have emerged to treat cardiovascular diseases. Renal sympathetic denervation (RDN) is the most influential non-pharmacological treatment method and was first reported by the Lancet in 2009. Although the negative conclusions of the Symplicity HTN-3 trial have hindered the application of RDN in resistant hypertension, there is increasing interest in RDN for the treatment of diseases other than hypertension because of its ability to inhibit sympathetic nerve overactivity. Therefore, we reviewed current studies about RDN with a focus on sympathetic nerve over-activation related diseases, such as, ventricular tachycardia, atrial fibrillation, myocardial remodeling, endothelium dysfunction, insulin resistance, obstructive sleep apnea, and so on.