Key result
Intensive renal denervation with at least 8 ablation points per artery reduced 24-hour systolic blood pressure by 27.4 mmHg at 6 months, with the magnitude of blood pressure reduction positively correlated with the number of ablation points.
Why the study?
To explore the blood pressure response to different ablation points of renal denervation in patients with resistant hypertension.
Does intensive renal denervation (≥8 ablation points per artery) improve blood pressure reduction compared to standard renal denervation (<8 points per artery) in patients with resistant hypertension?
Cohort (n=42)
No
Does intensive renal denervation (≥8 ablation points per artery) improve blood pressure reduction compared to standard renal denervation (<8 points per artery) in patients with resistant hypertension?
Absolute Event Rate: 27.4% vs 7.4%
p-value: p=<0.0001
Increasing the number of ablation points during renal denervation (≥8 points per artery) significantly enhances blood pressure reduction in patients with resistant hypertension without increasing adverse events.
May support intensified renal denervation protocols in resistant hypertension; leaves open superiority versus standard ablation in randomized trials.
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 (R2 = 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.
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Zhang et al. (2020) conducted a cohort in Resistant hypertension (n=42). Intensive renal denervation vs. Standard renal denervation (<8 points per artery) was evaluated on Decrease in 24-hour systolic blood pressure at 6 months (p=<0.0001). Intensive renal denervation with at least 8 ablation points per artery reduced 24-hour systolic blood pressure by 27.4 mmHg at 6 months, with the magnitude of blood pressure reduction positively correlated with the number of ablation points.
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