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Impact of local vascular lesions assessed with optical coherence tomography and ablation points on blood pressure reduction after renal denervation


Ghadri, Jelena-Rima; Gaehwiler, Roman; Jaguszewski, Milosz; Sudano, Isabella; Osipova, Julia; Schoenenberger-Berzins, Renate; Erne, Paul; Lüscher, Thomas F; Templin, Christian (2015). Impact of local vascular lesions assessed with optical coherence tomography and ablation points on blood pressure reduction after renal denervation. Swiss Medical Weekly, 145:w14102.

Abstract

UNLABELLED Local vascular injury is detectable with optical coherence tomography (OCT) after catheter-based renal denervation (RDN). However, it is unclear whether the number and type of vascular lesions or the number of ablation points could affect blood pressure (BP) reduction. The aim of the study was to assess the impact of vascular injury induced by RDN detected with OCT and the number of ablation points on BP response after 1, 3 and 6 months. METHODS RDN was either performed with a Simplicity catheter or an EnligHTNTM multielectrode basket followed by OCT. BP was recorded prospectively as office measurement and 24-hour ambulatory blood pressure monitoring (24-h ABPM) at each time point. Correlations between type and number of vascular lesions, as well as ablation points, on BP reduction were performed. RESULTS Out of 16 patients, two were lost to BP follow-up. We documented a BP reduction at 1, 3 and 6 months in both office and 24-h ABPM. The Δmean office systolic BP (SBP) reduction was -18.75 ± 24.55 mm Hg, -20.58 ± 16.92 mm Hg and -18.75 ± 29.39 mm Hg, respectively, and the Δmean 24h-ABPM SBP reduction was -6.50 ± 23.45 mm Hg, -16.88 ± 26.64 mm Hg and -13.89 ± 21.20 mm Hg, respectively. The number of vascular lesions did not correlate with office and 24h-SBP and diastolic BP reduction. However, there was a correlation between ablation points and office Δmean SBP reduction at 6 months (p <0.02). CONCLUSIONS Our study demonstrates for the first time that the number and type of vascular lesions as assessed with OCT did not predict the success of BP reduction after RDN. However, we observed a substantial decrease in office SBP in relation to the number of ablation points at 6 months.

Abstract

UNLABELLED Local vascular injury is detectable with optical coherence tomography (OCT) after catheter-based renal denervation (RDN). However, it is unclear whether the number and type of vascular lesions or the number of ablation points could affect blood pressure (BP) reduction. The aim of the study was to assess the impact of vascular injury induced by RDN detected with OCT and the number of ablation points on BP response after 1, 3 and 6 months. METHODS RDN was either performed with a Simplicity catheter or an EnligHTNTM multielectrode basket followed by OCT. BP was recorded prospectively as office measurement and 24-hour ambulatory blood pressure monitoring (24-h ABPM) at each time point. Correlations between type and number of vascular lesions, as well as ablation points, on BP reduction were performed. RESULTS Out of 16 patients, two were lost to BP follow-up. We documented a BP reduction at 1, 3 and 6 months in both office and 24-h ABPM. The Δmean office systolic BP (SBP) reduction was -18.75 ± 24.55 mm Hg, -20.58 ± 16.92 mm Hg and -18.75 ± 29.39 mm Hg, respectively, and the Δmean 24h-ABPM SBP reduction was -6.50 ± 23.45 mm Hg, -16.88 ± 26.64 mm Hg and -13.89 ± 21.20 mm Hg, respectively. The number of vascular lesions did not correlate with office and 24h-SBP and diastolic BP reduction. However, there was a correlation between ablation points and office Δmean SBP reduction at 6 months (p <0.02). CONCLUSIONS Our study demonstrates for the first time that the number and type of vascular lesions as assessed with OCT did not predict the success of BP reduction after RDN. However, we observed a substantial decrease in office SBP in relation to the number of ablation points at 6 months.

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Additional indexing

Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Hospital Zurich > Clinic for Cardiology
Dewey Decimal Classification:610 Medicine & health
Language:English
Date:2015
Deposited On:14 Jan 2016 07:29
Last Modified:05 Apr 2016 19:51
Publisher:EMH Swiss Medical Publishers
ISSN:0036-7672
Free access at:Publisher DOI. An embargo period may apply.
Publisher DOI:https://doi.org/10.4414/smw.2015.14102
PubMed ID:25658048

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