Department of Cardiology, the Second Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Cardiology, Dazu District People's Hospital, Chongqing, China.
J Hum Hypertens. 2019 Oct;33(10):716-724. doi: 10.1038/s41371-019-0244-5. Epub 2019 Sep 2.
Renal denervation (RDN) is a well-known innovative therapy for hypertension. However, the effects of global RDN on blood pressure (BP) lowering are quite variable. Insufficient and futile denervation is considered a major factor contributing to the variable results. Mapping renal nerves by renal nerve stimulation (RNS) is the most promising technique to improve the efficacy of RDN. We summarize the clinical and experimental data available regarding RNS-guided RDN and explain the roles of renal efferent nerves, afferent nerves and vagal nerves in BP changes. We further identify five different BP response patterns to RNS and provide an explanation of the underlying neuroanatomical basis.
肾去神经术（RDN）是一种著名的高血压创新治疗方法。然而，全球范围内 RDN 对降低血压（BP）的效果差异很大。不充分和无效的去神经支配被认为是导致结果差异的主要因素。通过肾神经刺激（RNS）对肾神经进行映射是提高 RDN 疗效的最有前途的技术。我们总结了有关 RNS 指导的 RDN 的临床和实验数据，并解释了肾传出神经、传入神经和迷走神经在血压变化中的作用。我们进一步确定了 RNS 引起的五种不同的血压反应模式，并解释了其潜在的神经解剖学基础。
