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ORIGINAL RESEARCH

Attenuation of Splanchnic Autotransfusion Following Noninvasive Ultrasound Renal Denervation: A Novel Marker of Procedural Success Manish Saxena, MBBS, MSc; Tariq Shour, BSc; Mussadiq Shah, PhD; Christopher B. Wolff, MBBS, PhD; Peter O. O. Julu, MBChB, PhD; Vikas Kapil, MBBS, PhD; David J. Collier, MBBS, PhD; Fu Liang Ng, MBBS, PhD; Ajay Gupta, MBBS, PhD; Armida Balawon, MBBS; Jane Pheby, BSc; Anne Zak, BSc; Gurvinder Rull, MBBS, PhD; Benjamin O’Brien, MBBS, PhD; Roland E. Schmieder, MBBS, PhD; Melvin D. Lobo, MBChB, PhD

Background-—Renal denervation has no validated marker of procedural success. We hypothesized that successful renal denervation would reduce renal sympathetic nerve signaling demonstrated by attenuation of a-1-adrenoceptor-mediated autotransfusion during the Valsalva maneuver.

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Methods and Results-—In this substudy of the Wave IV Study: Phase II Randomized Sham Controlled Study of Renal Denervation for Subjects With Uncontrolled Hypertension, we enrolled 23 subjects with resistant hypertension. They were randomized either to bilateral renal denervation using therapeutic levels of ultrasound energy (n=12) or sham application of diagnostic ultrasound (n=11). Within-group changes in autonomic parameters, office and ambulatory blood pressure were compared between baseline and 6 months in a double-blind manner. There was significant office blood pressure reduction in both treatment (16.127.3 mm Hg, P