Catheter-based radio-frequency renal nerve denervation lowers blood pressure in obese hypertensive swine model
Date
2016
Authors
Mahfoud, F.
Moon, L.
Pipenhagen, C.
Jensen, J.
Pathak, A.
Papademetriou, V.
Ewen, S.
Linz, D.
Böhm, M.
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Journal article
Citation
Journal of Hypertension, 2016; 34(9):1854-1862
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Felix Mahfoud, L. Boyce Moon, Catherine A. Pipenhagen, James A. Jensen, Atul Pathak, Vasilios Papademetriou, Sebastian Ewen, Dominik Linz, Michael Böhm
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Abstract
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.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.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 = 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.Catheter-based RDN, using a multielectrode system, resulted in a significant reduction in 24-h BP in this drug-naïve, hypertensive animal model.
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