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Improved Renal Denervation Mitigated Hypertension Induced by Angiotensin II Infusion

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Renal denervation: basic and clinical evidence.

Kenichi Katsurada^1,2, Keisuke Shinohara^3,4, Jiro Aoki⁵

¹Division of Cardiovascular Medicine, Department of Internal Medicine, Jichi Medical University School of Medicine, Shimotsuke, Tochigi, Japan.

Hypertension Research : Official Journal of the Japanese Society of Hypertension

|December 18, 2021

Summary

Renal denervation effectively treats hypertension and heart failure by modulating sympathetic and sensory nerves. This review covers animal studies and clinical trials of catheter-based renal denervation for cardiovascular diseases.

Keywords:

Heart failure Hypertension Radiofrequency renal denervation Sympathetic nervous system Ultrasound renal denervation

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Area of Science:

Nephrology
Cardiovascular Medicine
Neuroscience

Background:

Renal nerves regulate blood pressure and fluid balance; dysfunction is linked to cardiovascular diseases.
Renal nerves include sympathetic efferent and sensory afferent fibers influencing cardiovascular function.
Afferent renal nerves modulate central sympathetic outflow, impacting heart, kidney, and vascular resistance.

Purpose of the Study:

To review basic and clinical evidence of renal denervation for hypertension and heart failure.
To assess therapeutic effects and mechanisms of renal denervation in animal models and human trials.
To discuss future prospects for renal denervation in cardiovascular disease management.

Main Methods:

Review of animal models of hypertension and heart failure.
Analysis of clinical research on catheter-based renal denervation in hypertensive patients.
Assessment of randomized sham-controlled trials with various renal denervation devices.

Main Results:

Basic research demonstrates therapeutic effects of renal denervation in animal models.
Clinical trials using second-generation, radiofrequency, and ultrasound devices are evaluated.
Evidence for renal denervation's impact on cardiovascular parameters is synthesized.

Conclusions:

Renal denervation shows promise for treating hypertension and heart failure.
Both efferent and afferent renal nerve pathways contribute to its cardiovascular effects.
Further research and development are needed to optimize renal denervation therapy.