Role of Interventional Physiology in Renal Denervation Therapy for Resistant Hypertension

Abstract

Interventional physiology is a super specialty of physiology that involves procedures to study the physiological and technical aspects of blood flow, its velocity, Instantaneous wave-Free Ratio (iFR), pressure gradients in various organ systems like coronary, cerebral, renal, hepatic systems and recording and monitoring of various neurohormonal/neurophysiological signals, pressures during intraoperative and perioperative intervals and acts as an adjunct tool in differentiation between normal and abnormal events, responses and lesions. There have been significant advances in interventional cardiac (example: Evaluation using fractional flow reserve or non-hyperemic pressure ratios has become a gold standard for patients suffering from ischemic heart disease) and interventional neurophysiology [example: Intraoperative Neurophysiological Monitoring (IONM)], but there is strong need for increased enthusiasm and involvement of interventional physiologist in renal system as well. Renal Denervation (RDN) therapy for resistant hypertension is one of such fields and opportunity, where in pre-procedural work up and intra and post-procedural monitoring by interventional physiological techniques by a qualified interventional physiologist along with treating physicians can be game changer in a multidisciplinary team based therapeutical approach.