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Predictive Factors for Efficacy of Catheterbased Renal Denervation with Standard Ablation Catheter in Refractory Hypertension

Lixiong Zeng, Zhihui Zhang, Kan Yang, Fenglin Jiang, Hong Yuan, Xiaohong Tang, Weihong Jiang, Xiaoyan Wang

Objective: Renal denervation (RDN) has been demonstrated to reduce blood pressure durably, but its efficacy and safety is still unclear with standard radiofrequency ablation catheters, and related predictive factors remain unknown for its efficacy. Methods: Sixty patients with refractory hypertension were enrolled to undergo RDN procedure or drug therapy. Blood pressure was measured at baseline and 3-month follow-up. Eight of them excluded, forty-two patients underwent RDN treatment while the other ten served as controls. Results: The patients in RDN group and controls both had a high blood pressure (166.5/99.8 ± 12.6/12.2 vs. 170.4/102.5 ± 17.8/16.2 mmHg) in spite of the use of 3.8 ± 1.0 or 4.3 ± 1.2 types of anti-hypertensive drugs. Mean blood pressure was significantly decreased after RDN (153.0/99.8 ± 16.8/12.2 vs. 166.5/90.5 ± 12.6/11.5 mmHg, while no significant reduction of blood pressure was observed in controls. There were no severe adverse cardiovascular events in RDN group. Multiple linear regression analysis showed that impedance reduction, sex was related to the decrease of SBP, while impedance reduction, BMI and eGFR were correlated to the decrease of DBP . Conclusion: RDN with standard ablation catheters could safely reduce blood pressure in Chinese patients with refractory hypertension. The effectiveness of RDN appears to be associated with impedance change, sex, BMI and eGFR.