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Background <p>Hypertension may remain uncontrolled despite lifestyle measures, guideline-directed multidrug therapy, and renal denervation (RDN). Sympathetic overactivity contributes to persistent blood pressure (BP) elevation and cardiometabolic dysfunction. Given its central role in metabolic regulation and dense sympathetic innervation, the liver represents an attractive target for interventional neuromodulation.</p> Methods <p>This first-in-human ultrasound common hepatic artery denervation (CHA-D) was performed in a patient with recurrent uncontrolled hypertension and cardiometabolic comorbidity despite prior RDN and limited medical treatment options. Follow-up included ambulatory and office BP monitoring at 1 and 6&#xa0;months, proton density fat fraction magnetic resonance imaging, metabolic parameters, and patient-reported outcomes (SF-36, EQ-5D-5L). In addition, current clinical studies evaluating CHA-D and multi-organ denervation were reviewed.</p> Results <p>The procedure was completed successfully without intraprocedural complications. No hepatobiliary, pancreatic, or renal safety signal emerged during follow-up. Mean 24-h BP decreased from 179/88&#xa0;mmHg at baseline to 151/87&#xa0;mmHg at 1&#xa0;month and 139/83&#xa0;mmHg at 6&#xa0;months, corresponding to systolic BP reductions of 28 and 40&#xa0;mmHg, respectively, without intensification of antihypertensive therapy. Office BP decreased from 176/116&#xa0;mmHg at baseline to 125/85&#xa0;mmHg at 6&#xa0;months. Hepatic fat fraction declined from 16.2% to 11.5%, HbA1c from 6.2% to 5.9%, insulin requirement was reduced, and body weight decreased by 8&#xa0;kg. Patient-reported outcomes also improved during follow-up.</p> Conclusion <p>This first-in-human experience suggests CHA-D as a technically feasible and safe neuromodulatory approach with convergent signals of hemodynamic and cardiometabolic benefit, supporting further prospective evaluation of CHA-D in cardiovascular-kidney-metabolic syndrome.</p> Graphical Abstract <p></p>

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Ultrasound common hepatic artery denervation (CHA-D) as a novel neuromodulatory strategy for cardiovascular-kidney-metabolic syndrome: first-in-human experience

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年6月3日

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  • Mert Tokcan,
  • Franciska Diana Wolter,
  • Mathias Hohl,
  • Peter Fries,
  • Thorsten Kessler,
  • Saarraaken Kulenthiran,
  • Michael Böhm

摘要

Background

Hypertension may remain uncontrolled despite lifestyle measures, guideline-directed multidrug therapy, and renal denervation (RDN). Sympathetic overactivity contributes to persistent blood pressure (BP) elevation and cardiometabolic dysfunction. Given its central role in metabolic regulation and dense sympathetic innervation, the liver represents an attractive target for interventional neuromodulation.

Methods

This first-in-human ultrasound common hepatic artery denervation (CHA-D) was performed in a patient with recurrent uncontrolled hypertension and cardiometabolic comorbidity despite prior RDN and limited medical treatment options. Follow-up included ambulatory and office BP monitoring at 1 and 6 months, proton density fat fraction magnetic resonance imaging, metabolic parameters, and patient-reported outcomes (SF-36, EQ-5D-5L). In addition, current clinical studies evaluating CHA-D and multi-organ denervation were reviewed.

Results

The procedure was completed successfully without intraprocedural complications. No hepatobiliary, pancreatic, or renal safety signal emerged during follow-up. Mean 24-h BP decreased from 179/88 mmHg at baseline to 151/87 mmHg at 1 month and 139/83 mmHg at 6 months, corresponding to systolic BP reductions of 28 and 40 mmHg, respectively, without intensification of antihypertensive therapy. Office BP decreased from 176/116 mmHg at baseline to 125/85 mmHg at 6 months. Hepatic fat fraction declined from 16.2% to 11.5%, HbA1c from 6.2% to 5.9%, insulin requirement was reduced, and body weight decreased by 8 kg. Patient-reported outcomes also improved during follow-up.

Conclusion

This first-in-human experience suggests CHA-D as a technically feasible and safe neuromodulatory approach with convergent signals of hemodynamic and cardiometabolic benefit, supporting further prospective evaluation of CHA-D in cardiovascular-kidney-metabolic syndrome.

Graphical Abstract