Objective To explore the blood pressure response to different ablation points of renal denervation (RDN) in patients with resistant hypertension Methods A total of 42 cases with resistant hypertension treated by RDN in our center from 2013 to 2015 were retrospectively analyzed. The patients were divided into two groups according to the different ablation points of RDN: the standard treatment group (spiral ablation from near to proximal, with less than 8 points per artery) and the intensive treatment group (from near to far by spiral ablation, with at least 8 points per artery), with 21 patients in each group. The ablation parameters, including points, impedance, actual wattage, and actual temperature, were recorded intraoperatively. Renal angiography was performed again after RDN. Ambulatory blood pressure (ABP) images were taken for all patients at the baseline and 6 months after operation. Results The mean 24-h blood pressure of the standard treatment group was lower than that of the baseline (24-h systolic blood pressure decreased by 7.4 ± 10.6 mmHg and 24-h diastolic blood pressure decreased by 4.6 ± 6.1 mmHg), and the mean 24-h blood pressure decreased significantly from baseline to 6 months in the intensive treatment group (24–h systolic blood pressure decreased by 27.4 ± 11.4 mmHg, P < 0.0001; 24–h diastolic blood pressure decreased by 10.9 ± 9.6 mmHg, P = 0.005). There was a positive correlation between the decrease of systolic/diastolic 24-hour mean and the number of ablation points used in the procedure. The mean value of systolic and diastolic blood pressure was positively correlated with ablation points at 24-hour (R2 = 0.777 and 0.633 respectively, P < 0.01). There were no adverse events in either group after the operation and during the follow-up. Conclusions RDN could significantly reduce BP in patients with resistant hypertension. Our study showed that the antihypertensive effect appeared to be positively correlated with the number of ablation points.

中文翻译：

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不同去肾神经消融点对难治性高血压疗效的影响

目的探讨去肾神经（RDN）不同消融点对难治性高血压患者的血压反应。方法回顾性分析我中心2013-2015年接受RDN治疗的42例难治性高血压患者。根据RDN消融点的不同将患者分为两组：标准治疗组（从近端螺旋消融，每条动脉少于8个点）和强化治疗组（从近到远螺旋消融，每个动脉至少 8 个点），每组 21 名患者。术中记录消融参数，包括点数、阻抗、实际功率和实际温度。RDN 后再次进行肾血管造影。在基线和术后 6 个月为所有患者拍摄动态血压 (ABP) 图像。结果 标准治疗组平均 24 h 血压低于基线（24 h 收缩压下降 7.4 ± 10.6 mmHg，24 h 舒张压下降 4.6 ± 6.1 mmHg），强化治疗组的平均 24 小时血压从基线到 6 个月显着下降（24 小时收缩压下降 27.4 ± 11.4 mmHg，P < 0.0001；24 小时舒张压下降 10.9 ± 9.6 mmHg，P = 0.005)。收缩压/舒张压 24 小时平均值的降低与手术中使用的消融点数呈正相关。收缩压和舒张压的平均值与24小时消融点呈正相关（R2分别为0.777和0.633，P<0.01）。两组术后及随访期间均未发生不良事件。结论 RDN可显着降低难治性高血压患者的血压。我们的研究表明，抗高血压作用似乎与消融点的数量呈正相关。