{"id":"46088","type":"article","url":"https://hartvaat.nl/2026/04/09/aanvullende-ablatie-van-het-aorticorenale-ganglion-versterkt-het-bloeddrukeffect/","title":"Aanvullende ablatie van het aorticorenale ganglion versterkt het bloeddrukeffect van renale denervatie","title_en":"Aorticorenal Ganglion Ablation Enhances Blood Pressure Reduction After Renal Denervation","category":"hypertensie","category_label":"Hypertensie","professions":["cardioloog"],"tags":[],"journal":"Hypertension","doi":"https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26719","source_url":"https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/HYPERTENSIONAHA.125.26719","authors":["Yuxiang Long"],"significance":6,"published":"2026-07-23","source_date":"2026-04-09","image":"","kennis":["https://hartvaat.nl/kennis/hypertensie/esc-richtlijn-hypertensie-2024/","https://hartvaat.nl/kennis/hypertensie/wat-is-hypertensie/"],"congress":"","summary_en":"The aorticorenal ganglion (ARG) is an upstream component of renal sympathetic fibres and a possible new target in hypertension. In this exploratory study, patients with uncontrolled hypertension underwent renal denervation (RDN); if blood pressure rose during high-frequency stimulation at the ARG, that ganglion was additionally ablated (RDN+ARG). In 41 patients (20 RDN, 21 RDN+ARG), mean 24-hour systolic blood pressure at three months fell by 9.7 mmHg after RDN alone and by 18.2 mmHg after RDN+ARG — a difference of 7.5 mmHg, with no major complications. In a canine model, ARG ablation reduced renal and systemic sympathetic activity more than RDN alone. The ARG thus appears a key regulator of sympathetic tone and a promising target; adjunctive ARG ablation with RDN warrants validation in larger trials.","created":"2026-07-03T20:27:18Z","updated":"2026-07-04T19:26:47Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Het aorticorenale ganglion (ARG) is een bovenstroomse schakel in de renale sympathische zenuwbanen en mogelijk een nieuw aangrijppunt bij hypertensie. In deze exploratieve studie kregen patiënten met onbehandelbare hypertensie een renale denervatie (RDN); bij een bloeddrukstijging tijdens hoogfrequente stimulatie ter plaatse van het ARG werd aanvullend dat ganglion geableerd (RDN+ARG). Bij 41 patiënten (20 RDN, 21 RDN+ARG) daalde de gemiddelde 24-uurs systolische bloeddruk na drie maanden met 9,7 mmHg na RDN alleen en met 18,2 mmHg na RDN+ARG — een verschil van 7,5 mmHg, zonder ernstige complicaties. In een hondenmodel verminderde ARG-ablatie de renale en systemische sympathische activiteit sterker dan RDN alleen. Het ARG lijkt dus een belangrijke regelaar van de sympathische tonus en een veelbelovend doelwit; aanvullende ARG-ablatie bij RDN verdient validatie in grotere trials.","abstract_original":"BACKGROUND:The aorticorenal ganglion (ARG), an upstream component of renal sympathetic fibers, may represent a novel target for autonomic modulation in hypertension. This study evaluated the effects of adjunctive ARG ablation after renal denervation (RDN) on blood pressure (BP) and its autonomic mechanisms.METHODS:Patients with uncontrolled hypertension scheduled for RDN were enrolled, and additional ablation was performed if an elevation in SBP was observed by high-frequency stimulation at the ARG region (RDN+ARG ablation). This exploratory analysis assessed the change in 24-hour average ambulatory systolic BP from baseline to 3 months. To explore the effects of ARG ablation on BP and sympathetic activity, we compared ARG ablation with RDN in a canine model.RESULTS:A total of 41 patients (n=20 RDN; n=21 RDN+ARG ablation) were enrolled. At 3 months, the reduction in 24-hour average ambulatory systolic BP from baseline was −9.7±10.8 mm Hg in the RDN group and −18.2±10.8 mm Hg in the RDN+ARG ablation group, with a between-group difference of −7.5 mm Hg (95% CI, −13.9 to −1.2 mm Hg;P=0.021) after adjusting for baseline ambulatory systolic BP. No major procedure-related complications were observed in both groups. In canines, ARG ablation significantly reduced the renal sympathetic innervation and the systemic sympathetic activity compared with RDN, with enhancing SBP-lowering effect.CONCLUSIONS:These results establish the ARG as a pivotal regulator of systemic sympathetic tone and a promising therapeutic target for hypertension. Additional ARG ablation to RDN may represent a more effective interventional strategy, warranting validation in large-scale clinical trials.REGISTRATION:URL:https://www.clinicaltrials.gov; Unique identifier: NCT05590871."}