Catheter-based radio-frequency renal nerve denervation lowers blood pressure in obese hypertensive swine model. Issue 9 (September 2016)

• Record Type: Journal Article
• Authors: Mahfoud, Felix; Moon, L. Boyce; Pipenhagen, Catherine A.; Jensen, James A.; Pathak, Atul; Papademetriou, Vasilios; Ewen, Sebastian; Linz, Dominik; Böhm, Michael
• Is Part Of: Journal of hypertension. Volume 34:Issue 9(2016:Sep.)
• Publication Date: 2016-09
• Subjects: drug-naïve -- Ossabaw pigs -- renal denervation -- sympathectomy -- uncontrolled hypertension; Hypertension -- Periodicals; Hypertension -- Periodicals; 616.132005
• DOI: 10.1097/HJH.0000000000001021
• Languages: English
• ISSNs: 1473-5598

Abstract

Abstract : Objectives: Radio-frequency renal denervation (RDN) therapy is under investigation for the treatment of uncontrolled hypertension. Data in hypertensive, drug-naïve large animal models using RDN is limited. Methods: A cohort of Ossabaw swine ( N = 9) was implanted with telemetry monitors, enrolled on a high calorie-feed regimen and randomly assigned to RDN. Blood pressure (BP) data were separated and analyzed according to the following epoch definitions: 24-h (h), most-active-h, light-h, and dark-h. Results: The mean weight increased by 45% from 86.5 ± 2.5 kg at telemetry implant (day 87) to 125.2 ± 4.5 kg at time of RDN therapy (day 227). Hypertension developed in all swine (24-h BP: 169.5/128.3 ± 5.8/5.1 mmHg pre-RDN). RDN resulted in significant reductions in noradrenaline kidney tissue concentration by 63%. Significant BP reductions were documented at 45 days post-RDN in all defined interday epochs, except for the dark-h period. The most pronounced SBP/DBP reduction was 12.4/11.2 mmHg ( P < 0.05), observed during the most-active-h period. Animals continued to gain weight after the RDN procedure to the end of the study at 90 days (125.2 ± 4.5–138.5 ± 6.6 kg, P < 0.001). At 90 days post-RDN, the mean 24-h BP returned near pre-RDN baseline values. Given the strong relationship of BP to weight ( R 2 = 0.87, P < 0.001), group mean SBP/DBP was normalized by weight resulting in significant and continued reductions at both 45 and 90 days post-RDN across all intradaily epochs. Conclusion: Catheter-based RDN, using a multielectrode system, resulted in a significant reduction in 24-h BP in this drug-naïve, hypertensive animal model. Abstract : Supplemental Digital Content is available in the text