Influence of Renal Sympathetic Denervation in Patients with Early-Stage Heart Failure Versus Late-Stage Heart Failure
Influence of Renal Sympathetic Denervation in Patients with Early-Stage Heart Failure Versus Late-Stage Heart Failure
复制标题
去肾交感神经对早期心力衰竭患者与晚期心力衰竭患者的影响
DOI：
10.1536/ihj.16-413
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发表时间：
2018-01-01
影响因子：
1.5
通讯作者：
Shan, Qijun
中科院分区：
文献类型：
--
作者：
Geng, Jie;Chen, Chun;Shan, Qijun
肾交感神经切除术（RDN）目前正在心力衰竭（HF）的多项研究中进行研究。我们的目的是评估RDN在HF患者中的安全性和有效性，并确定哪些患者可以获得RDN的更多有益效果。共有17例连续HF患者入组本研究。在RDN前和RDN后12个月进行临床症状、诊室血压和实验室检查，并进行超声心动图检查。分析了所有患者和基于HF持续时间的两个亚组（第1组：HF持续时间3年，n = 8）从基线到12个月的变化。所有患者的RDN手术均获得成功，未记录到手术相关并发症。与基线相比，所有患者和第1组的左心室射血分数（LVEF）均显著增加（P < 0.05），而第2组未发生。第1组的LAD、LVD和RVD也显着减少（均P < 0.05）。在12个月时，所有患者和第1组患者的TNF-α和CRP均显著降低。第2组中未记录到超声心动图参数、6分钟步行距离、TNF-α或CRP的明显变化。在随访的第12个月，两组中均未观察到BNP的变化。RDN可改善心衰患者心功能，并使炎性标志物明显下降。我们还发现，早期HF患者可以从RDN中获益更多。
Renal sympathetic denervation (RDN) is currently being investigated in multiple studies of heart failure (HF). Our aim was to assess the safety and effectiveness of RDN in patients with HF, and determine which patients could achieve more beneficial effects of RDN. A total of 17 consecutive patients with HF were enrolled in the study. Clinical symptoms, office blood pressure, and laboratory results were obtained and echocardiography was performed before and 12 months after RDN. Changes from baseline to 12 months were analyzed for all patients and for two subgroups based on HF duration (group 1: HF duration 3 years, n = 8). The RDN procedure was successful in all patients and no procedure-related complications were documented. In comparison to baseline, there was a significant increase in left ventricular ejection fraction (LVEF) in all patients and group 1 (P < 0.05 for both), which did not happen in group 2. LAD, LVDs, and RVD also showed a significant reduction in group 1 (P < 0.05 for both). At 12 months, the reductions in TNF-a and CRP were significant for all patients and for patients in group 1 separately. No obvious changes in echocardiographic parameters, 6-minute walking distance, TNF-alpha, or CRP were recorded in group 2. No changes in BNP in either group were observed at the 12th month of follow-up. RDN could improve cardiac function and led to a significant drop in inflammatory markers in patients with HF. We also found that patients in early-stage HF could benefit more from RDN.