Increased sympathetic nervous activity is one of main contributors to pathogenesis and progression of hypertension. Renal denervation (RDN) has been demonstrated as a potential therapy for treatment of hypertension; however, lack of indicators of intra-/post-procedure results in inconsistent clinical outcomes. Renal nerve stimulation (RNS), a simple and promising method, could evoke elevated blood pressure as an intraoperative indicator for RDN. But related researches on patterns of blood pressure responses to RNS are still incomplete. To investigate and categorize the phenotypes of blood pressure response to RNS and heart rate alteration before and after RNS, 24 Chinese Kunming dogs were used to perform RNS from bifurcation to ostium of renal arteries after angiography, and a total of 483 stimulated sites were complete. We identified five different patterns of blood pressure response to RNS in 483 stimulated sites, (1) continuous ascending and finally keeping steady above baseline (26.9%), (2) declining and then rising over baseline (11.8%), (3) declining and then rising but below baseline (14.5%), (4) fluctuating in the vicinity of baseline (39.5%), and (5) continuous declining and finally keeping steady below baseline (7.2%), and found no difference in RR intervals among five blood pressure responses before and after renal nerve stimulation. Renal nerve stimulation could elicit different patterns of blood pressure response, which could potentially assist in distinguishing sympathetic-excitatory sites and sympathetic-inhibitory sites from mixed nerve components, which might help to improve the efficacy of RDN.
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The authors would like to acknowledge Changzhi Zhang and Jie Yang for their help in intervention procedures.
This work was supported by the General Project of the National Natural Science Foundation of China under Grant No.82000471 and General Project from Chongqing Municipal Health Bureau under Grant No.2016MSXM023.
The experimental protocol was approved by the Animal Experimentation Ethics Committee of Chongqing Medical University, in accordance with the guidelines of National Institutes of Health for the care and use of laboratory animals.
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Associate Editor Marat Fudim oversaw the review of this article
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Zhou, H., Li, Y., Xu, Y. et al. Mapping Renal Innervations by Renal Nerve Stimulation and Characterizations of Blood Pressure Response Patterns. J. of Cardiovasc. Trans. Res. (2021). https://doi.org/10.1007/s12265-021-10149-1
- Renal denervation
- Renal nerve stimulation
- Blood pressure response