Effects of renal sympathetic denervation using saline-irrigated radiofrequency ablation catheter on the activity of the renin-angiotensin system and endothelin-1.

INTRODUCTION

Excessive activation of the sympathetic nervous system (SNS) and the renin-angiotensin system (RAS) are crucial and interacted closely in the pathogenesis of chronic cardiovascular diseases. This study investigated the effects of renal denervation (RDN) on the RAS.

MATERIALS AND

METHODS

Eight Chinese Kunming dogs underwent bilateral RDN utilizing saline-irrigated radiofrequency ablation catheter. Blood pressure (BP) measurements, blood sampling assays and renal angiography were performed at baseline, 30 min, one month and three months after ablation.

RESULTS

During three months of follow-up, RDN caused a significant and uniform reduction in plasma level of renin, angiotensin II, and endothelin-1(ET-1), with the reduction of -5.7±6.8 (p=0.049), -19.4±19.3 (p=0.025), and -22.4±21 pg/ml (p=0.02) for plasma renin, -10.6±7.2 (p=0.004), -15.9±8.8 (p=0.001), and -15.2±9.6 pg/ml (p=0.003) for plasma angiotensin II, as well as -3.9±3 (p=0.007), -10.8±5 (p<0.001), and -14.6±6.1 pg/ml (p<0.001) for plasma ET-1. RDN utilizing a saline-irrigated catheter also caused a progressive and substantial BP reduction of -19±22/-8±13, -30±13/-13±14, and -36±20/-16±14 mm Hg (p=0.045, p<0.001, and p<0.002 for systolic BP; p=0.14, p=0.036, and p=0.014 for diastolic BP) without ablation-related complications.

CONCLUSION

RDN substantially decreased BP and also significantly decreased the plasma levels of RAS and ET-1, which might be implicated in the mechanism of BP reduction by RDN.