AIMS To determine whether renal denervation (RDN) in hypertensive patients affects the platelet activation status. METHODS AND RESULTS We investigated the effect of RDN on the platelet activation status in 41 hypertensive patients undergoing RDN. Ambulatory blood pressure (BP), plasma sympathetic neurotransmitter Neuropeptide Y, and platelet activation markers were measured at baseline, at 3 months, and 6 months after RDN. RDN significantly decreased BP at 3 months (150.6 ± 11.3/80.9 ± 11.4 mmHg to 144.7 ± 12.0/77.1 ± 11.1 mmHg; P < 0.01) and at 6 months (144.3 ± 13.8/78.3 ± 11.1 mmHg; P < 0.01). Plasma levels of the sympathetic neurotransmitter Neuropeptide Y, an indicator of sympathetic nerve activity, were significantly decreased at 3 months (0.29 ± 0.11 ng/mL to 0.23 ± 0.11 ng/mL; P < 0.0001) and at 6 months (0.22 ± 0.12 ng/mL; P < 0.001) after RDN. This was associated with a reduction in platelet membrane P-selectin expression (3 months, P < 0.05; 6 months, P < 0.05), soluble P-selectin (6 months, P < 0.05), circulating numbers of platelet-derived extracellular vesicles (EVs) (3 months, P < 0.001; 6 months, P < 0.01), and phosphatidylserine expressing EVs (3 months, P < 0.001; 6 months, P < 0.0001), indicative of a reduction in platelet activation status and procoagulant activity. Only patients who responded to RDN with a BP reduction showed inhibition of P-selectin expression at 3 months (P < 0.05) and 6 months (P < 0.05) as well as reduction of glycoprotein IIb/IIIa activation at 3 months (P < 0.05). Notably, 13 patients who took aspirin did not show significant reduction in platelet P-selectin expression following RDN. CONCLUSION Our results imply a connection between the sympathetic nervous system and the platelet activation status and provide a potential mechanistic explanation by which RDN can have favourable effects towards reducing cardiovascular complications.

中文翻译：

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成功的肾神经支配降低了高血压患者的血小板活化状态。

目的确定高血压患者的肾脏神经支配（RDN）是否影响血小板活化状态。方法和结果我们调查了RDN对41例接受RDN的高血压患者血小板活化状态的影响。动态血压（BP），血浆交感神经递质神经肽Y和血小板活化标志物在基线，RDN后3个月和6个月时进行测量。RDN在3个月（150.6±11.3 / 80.9±11.4 mmHg）至144.7±12.0 / 77.1±11.1 mmHg; P <0.01）和6个月（144.3±13.8 / 78.3±11.1 mmHg; P <0.01）时，血压显着降低。在3个月（0.29±0.11 ng / mL到0.23±0.11 ng / mL; P <0.0001）和6个月（0.22±0.12 ng）时，交感神经递质Neuropepty Y的血浆水平显着降低，这是交感神经活动的指标。 / mL; P < RDN之后的0.001）。这与血小板膜P-选择素表达减少（3个月，P <0.05； 6个月，P <0.05），可溶性P-选择素（6个月，P <0.05），血小板衍生的细胞外囊泡的循环数减少有关。 （EV）（3个月，P <0.001； 6个月，P <0.01）和表达磷脂酰丝氨酸的EV（3个月，P <0.001； 6个月，P <0.0001），表明血小板活化状态和促凝活性降低。只有对RD降低有反应的RDN患者在3个月（P <0.05）和6个月（P <0.05）时P-选择素表达受到抑制，而在3个月时糖蛋白IIb / IIIa激活降低（P <0.05 ）。值得注意的是，服用阿司匹林的13名患者在RDN后血小板P选择素表达没有明显降低。