LAUSR

Objective: Renal nerve stimulation (RNS) can be used to elicit increases in blood pressure (BP) during renal denervation (RDN) to target sympathetic nerve tissue. In a smaller cohort RNS induced BP changes proved to predict ambulatory BP response to RDN during follow up. The goal of the current study was to validate the correlation between RNS-induced BP changes during RDN and the ambulatory BP changes during follow up Design and method: Forty-two patients with drug-resistant hypertension were included in a single-center prospective cohort. RNS was performed under general anesthesia at different sites in the right and left renal arteries, both before and after RDN. RNS-induced BP and heart rate changes were monitored. Results: RNS resulted in a mean maximum systolic BP increase of 46 ± 20 mmHg before RDN and a mean increase of 13 ± 12 mmHg after RDN (P < 0.001). Average systolic ABPM was 145 ± 15 mmHg before RDN and decreased to 135 ± 12 mmHg at 3- to 6-month follow-up (P = 0.005). Changes in RNS-induced BP increase before versus immediately after RDN and changes in ABPM were correlated, both for systolic BP (R = 0.39, P = 0.039) and diastolic BP (R = 0.40, P = 0.034). RNS-induced maximum BP increase before RDN had a correlation of R = 0.45 (P = 0.013) for systolic and R = 0.51 (P = 0.004) for diastolic ABPM changes. Conclusions: RNS-induced BP changes before versus after RDN were correlated with changes in 24-hour ABPM 3 to 6 months after RDN. This finding strongly support the use of RNS as a procedural endpoint for RDN.