Abstract
Patients with treatment-resistant arterial hypertension exhibited profound reductions in single sympathetic vasoconstrictor fiber firing rates after renal nerve ablation. In contrast, integrated multi-unit muscle sympathetic nerve activity (MSNA) changed little or not at all. We hypothesized that conventional MSNA analysis may have missed single fiber discharges, thus, obscuring sympathetic inhibition after renal denervation. We studied patients with difficult-to-control arterial hypertension (age 45-74 years) before, 6 (n = 11), and 12 months (n = 8) after renal nerve ablation. Electrocardiogram, respiration, brachial, and finger arterial blood pressure (BP), as well as the MSNA and raw MSNA signals were analyzed. We detected MSNA action-potential spikes using 2 stage kurtosis wavelet denoising techniques to assess mean, median, and maximum spike rates for each beat-to-beat interval. Supine heart rate and systolic BP did not change at 6 (ΔHR: -2 ± 3 bpm; ΔSBP: 2 ± 9 mm Hg) or at 12 months (ΔHR: -1 ± 3 mm Hg, ΔSBP: -1 ± 9 mm Hg) after renal nerve ablation. Mean burst frequency and mean spike frequency at baseline were 34 ± 3 bursts per minute and 8 ± 1 spikes per second. Both measurements did not change at 6 months (-1.4 ± 3.6 ...Continue Reading
References
Apr 1, 1990·Acta Physiologica Scandinavica·N Sjöblom-Widfeldt, H Nilsson
Nov 1, 1974·Acta Physiologica Scandinavica·R G Hallin, H E Torebjörk
Dec 15, 1994·The Journal of Physiology·V G MacefieldA B Vallbo
Nov 14, 1996·The New England Journal of Medicine·H P SchobelR E Schmieder
Jun 4, 1998·Circulation·G GrassiG Mancia
Aug 8, 1998·Journal of Neuroscience Methods·A Szucs
Sep 24, 1999·Circulation·J P GreenwoodD A Mary
Oct 20, 1999·Circulation·V G MacefieldM Elam
Jun 19, 2002·Journal of Applied Physiology·Mikael ElamVaughan Macefield
Oct 9, 2002·Circulation·Martin HausbergKarl Heinz Rahn
Mar 6, 2003·IEEE Transactions on Bio-medical Engineering·André DiedrichRichard Shiavi
Mar 8, 2003·Hypertension·Gerald F DiBona
Jun 11, 2003·Circulation·Jens TankJens Jordan
Jun 21, 2006·Hypertension·Shaohua YeVito M Campese
Nov 7, 2006·Journal of Neuroscience Methods·Robert J BrychtaAndré Diedrich
Jan 31, 2007·IEEE Transactions on Bio-medical Engineering·Robert J BrychtaAndré Diedrich
Jun 28, 2008·International Journal of Cardiology·Antonio C P BarrettoCarlos E Negrão
Apr 1, 2009·Lancet·Henry KrumMurray Esler
Aug 28, 2009·The New England Journal of Medicine·Markus P SchlaichMurray D Esler
Jan 27, 2010·Hypertension·Karsten HeusserJens Jordan
Jul 14, 2010·Hypertension·Elisabeth LambertGavin Lambert
Jun 7, 2011·Autonomic Neuroscience : Basic & Clinical·Toni BreskovicZeljko Dujic
Mar 24, 2012·Journal of Neurophysiology·Aryan Salmanpour, J Kevin Shoemaker
Oct 10, 2012·Hypertension·Julia BrinkmannJens Tank
Nov 23, 2012·Hypertension·Dagmara HeringMarkus P Schlaich
Apr 2, 2013·Respiratory Physiology & Neurobiology·Petra Zubin MaslovZeljko Dujic
Apr 16, 2014·Hypertension·Dagmara HeringMarkus P Schlaich
Jul 17, 2014·International Journal of Cardiology·E E VinkP J Blankestijn
Nov 19, 2014·Hypertension·Lindsea C BoothClive N May
Dec 4, 2014·Circulation·Philip J MillarJohn S Floras
Apr 1, 2015·Hypertension·Guido GrassiGiuseppe Mancia