Hypertension (Dallas, Tex. : 1979) · 2026
Aorticorenal Ganglion Ablation Enhances Blood Pressure Reduction After Renal Denervation.
СтатьяМногоцентровое исследованиеРандомизированное исследованиеНазвание и аннотация: Перевод в очереди
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Long Yuxiang, Lai Yinchuan, Ren Yiwen, Ma Xiaomin, Li Dan, Chen Liyuan, Liao Xinyue, Xia Tianli, Liu Zengzhang, Ling Zhiyu, Chen Yunlin, Zhou Hao, Yin Yuehui
Аннотация
BACKGROUND: The aorticorenal ganglion (ARG), an upstream component of renal sympathetic fibers, may represent a novel target for autonomic modulation in hypertension. This study evaluated the effects of adjunctive ARG ablation after renal denervation (RDN) on blood pressure (BP) and its autonomic mechanisms.
METHODS: Patients with uncontrolled hypertension scheduled for RDN were enrolled, and additional ablation was performed if an elevation in SBP was observed by high-frequency stimulation at the ARG region (RDN+ARG ablation). This exploratory analysis assessed the change in 24-hour average ambulatory systolic BP from baseline to 3 months. To explore the effects of ARG ablation on BP and sympathetic activity, we compared ARG ablation with RDN in a canine model.
RESULTS: A total of 41 patients (n=20 RDN; n=21 RDN+ARG ablation) were enrolled. At 3 months, the reduction in 24-hour average ambulatory systolic BP from baseline was -9.7±10.8 mm Hg in the RDN group and -18.2±10.8 mm Hg in the RDN+ARG ablation group, with a between-group difference of -7.5 mm Hg (95% CI, -13.9 to -1.2 mm Hg; P=0.021) after adjusting for baseline ambulatory systolic BP. No major procedure-related complications were observed in both groups. In canines, ARG ablation significantly reduced the renal sympathetic innervation and the systemic sympathetic activity compared with RDN, with enhancing SBP-lowering effect.
CONCLUSIONS: These results establish the ARG as a pivotal regulator of systemic sympathetic tone and a promising therapeutic target for hypertension. Additional ARG ablation to RDN may represent a more effective interventional strategy, warranting validation in large-scale clinical trials.
REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT05590871.
METHODS: Patients with uncontrolled hypertension scheduled for RDN were enrolled, and additional ablation was performed if an elevation in SBP was observed by high-frequency stimulation at the ARG region (RDN+ARG ablation). This exploratory analysis assessed the change in 24-hour average ambulatory systolic BP from baseline to 3 months. To explore the effects of ARG ablation on BP and sympathetic activity, we compared ARG ablation with RDN in a canine model.
RESULTS: A total of 41 patients (n=20 RDN; n=21 RDN+ARG ablation) were enrolled. At 3 months, the reduction in 24-hour average ambulatory systolic BP from baseline was -9.7±10.8 mm Hg in the RDN group and -18.2±10.8 mm Hg in the RDN+ARG ablation group, with a between-group difference of -7.5 mm Hg (95% CI, -13.9 to -1.2 mm Hg; P=0.021) after adjusting for baseline ambulatory systolic BP. No major procedure-related complications were observed in both groups. In canines, ARG ablation significantly reduced the renal sympathetic innervation and the systemic sympathetic activity compared with RDN, with enhancing SBP-lowering effect.
CONCLUSIONS: These results establish the ARG as a pivotal regulator of systemic sympathetic tone and a promising therapeutic target for hypertension. Additional ARG ablation to RDN may represent a more effective interventional strategy, warranting validation in large-scale clinical trials.
REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT05590871.