OBJECTIVES: We investigated the acute and chronic effects of catheter-based renal sympathetic denervation (RSD) on renal hemodynamics assessed by average peak velocity (APV), renal blood flow (RBF), renal flow reserve (RFR) and resistive index (RI). BACKGROUND: Sympathetic overdrive is accompanied by impaired RBF, whereas there is no data on the effects of transcatheter RSD on renal hemodynamic balance. METHODS: Before and post-RSD (acutely and after 1 month), in 9 farm swines we measured APV by a 0.014-inch Doppler flow wire placed in the stem of the renal artery under baseline and hyperemic conditions, induced by intrarenal dopamine (50 μg/kg). RFR was calculated as the ratio of hyperemic to basal peak velocity, and RI was estimated as (peak systolic velocity-end-diastolic velocity)/peak systolic velocity. RSD was achieved via the lumen of the main renal artery with a specifically designed catheter connected to a radiofrequency generator according to prespecified algorithm. RESULTS: APV and RBF increased acutely post ablation in all animals, compared to APV and RBF before ablation (61.44 ± 32.6 vs 20.44 ± 6.38 cm/s, p<0.001 and 407.4 ± 335.1 vs 161.1 ± 76.6 ml/min, p=0.003; respectively), whereas RFR and RI were reduced (1.51 ± 0.59 vs 2.85 ± 1.33, p<0.001 and 0.67 ± 0.07 vs 0.74 ± 0.07, p=0.005; respectively). One month post ablation APV and RBF compared to APV and RBF before ablation remained significantly higher whereas RFR and RI remained lower as compared to baseline. CONCLUSIONS: Catheter-based RSD exerts acute and chronic effects on renal hemodynamics in a large animal model. If confirmed in humans RBF parameters may be used as direct markers of successful RSD.
OBJECTIVES: We investigated the acute and chronic effects of catheter-based renal sympathetic denervation (RSD) on renal hemodynamics assessed by average peak velocity (APV), renal blood flow (RBF), renal flow reserve (RFR) and resistive index (RI). BACKGROUND: Sympathetic overdrive is accompanied by impaired RBF, whereas there is no data on the effects of transcatheter RSD on renal hemodynamic balance. METHODS: Before and post-RSD (acutely and after 1 month), in 9 farm swines we measured APV by a 0.014-inch Doppler flow wire placed in the stem of the renal artery under baseline and hyperemic conditions, induced by intrarenal dopamine (50 μg/kg). RFR was calculated as the ratio of hyperemic to basal peak velocity, and RI was estimated as (peak systolic velocity-end-diastolic velocity)/peak systolic velocity. RSD was achieved via the lumen of the main renal artery with a specifically designed catheter connected to a radiofrequency generator according to prespecified algorithm. RESULTS: APV and RBF increased acutely post ablation in all animals, compared to APV and RBF before ablation (61.44 ± 32.6 vs 20.44 ± 6.38 cm/s, p<0.001 and 407.4 ± 335.1 vs 161.1 ± 76.6 ml/min, p=0.003; respectively), whereas RFR and RI were reduced (1.51 ± 0.59 vs 2.85 ± 1.33, p<0.001 and 0.67 ± 0.07 vs 0.74 ± 0.07, p=0.005; respectively). One month post ablation APV and RBF compared to APV and RBF before ablation remained significantly higher whereas RFR and RI remained lower as compared to baseline. CONCLUSIONS: Catheter-based RSD exerts acute and chronic effects on renal hemodynamics in a large animal model. If confirmed in humans RBF parameters may be used as direct markers of successful RSD.
Authors: Jennifer Keegan; Hitesh C Patel; Robin M Simpson; Raad H Mohiaddin; David N Firmin Journal: J Cardiovasc Magn Reson Date: 2015-02-04 Impact factor: 5.364
Authors: Adelina Doltra; Arthur Hartmann; Philipp Stawowy; Leonid Goubergrits; Titus Kuehne; Ernst Wellnhofer; Rolf Gebker; Christopher Schneeweis; Bernhard Schnackenburg; Murray Esler; Eckart Fleck; Sebastian Kelle Journal: PLoS One Date: 2016-03-22 Impact factor: 3.240
Authors: Willemien L Verloop; Lisette E G Hubens; Wilko Spiering; Pieter A Doevendans; Roel Goldschmeding; Ronald L A W Bleys; Michiel Voskuil Journal: PLoS One Date: 2015-11-20 Impact factor: 3.240