2021年欧洲高血压学会关于经导管去肾交感神经术的立场文件详介
孙宁玲
摘要(Abstract):
<正>2018年欧洲高血压学会(EuropeanSocietyof Hypertension,ESH)/欧洲心脏病学会(European Society of Cardiology,ESC)曾在其发布的高血压管理指南中指出:"由于经导管去肾交感神经术(renal denervation,RDN)作为一种有效的降血压技术的临床证据相互矛盾""不建议将器械治疗作为高血压的常规疗法,除非在临床研究和随机对照试验(randomized controlled trial,RCT)的背景支持下,进一步获得了这一疗法的安全性和有效性证据"~([1])。在其后3年里,器械治疗的有效性和安全性的新数据逐步获得。
关键词(KeyWords): 经导管去肾交感神经术;高血压;安全性
基金项目(Foundation):
作者(Author): 孙宁玲
参考文献(References):
- [1] Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH guidelines for the management of arterial hypertension:The task force for the management of arterial hypertension of the european society of cardiology and the european society of hypertension:The task force for the management of arterial hypertension of the european society of cardiology and the european society of hypertension. J Hypertens, 2018, 36(10):1953-2041.
- [2] Schmieder RE,Mahfoud F,Mancia G,et al. European Society of Hypertension position paper on renal denervation 2021. J Hypertens,2021,39(9):1733-1741.
- [3] Schmieder RE. Renal denervation:where do we stand and what is the relevance to the nephrologist? Nephrol Dial Transplant,2020,11:1-7.
- [4] Mahfoud F, Azizi M, Ewen S, et al. Proceedings from the3rd european clinical consensus conference for clinical trials in device-based hypertension therapies. Eur Heart J, 2020, 41(16):1588-1599.
- [5] Mahfoud F, Schmieder RE, Azizi M, et al. Proceedings from the 2nd european clinical consensus conference for device-based therapies for hypertension:State of the art and consider-ations for the future. Eur Heart J,2017,38(44):3272-3281.
- [6] Weber MA, Kirtane AJ, Weir MR, et al. The reduce htn:Reinforce:randomized, sham-controlled trial of bipo-lar radiofrequency renal denervation for the treatment of hypertension.JACC Cardiovasc Interv,2020,13(4):461-470.
- [7] Townsend RR, Mahfoud F, Kandzari DE, et al. Catheterb a s e d r e n a l d e n e r v a t i o n i n p a t i e n t s w i t h u n c o n t r o l l e d hypertension in the absence of antihypertensive medications(SPYRAL HTN-OFF MED):a randomised, shamcontrolled, proof-of-concept trial. Lancet,2017,390(10108):2160-2170.
- [8] Kandzari DE, B?hm M, Mahfoud F,et al. Ef fect of renal denervation on blood pressure in the presence of antihypertensive drugs:6-month e fficacy and safety results from the SPYRAL HTNON MED proof-of-concept randomised trial. Lancet, 2018, 391(10137):2346-2355.
- [9] Azizi M, Schmieder RE, Mahfoud F, et al. Endovascular ultrasound renal denervation to treat hypertension(RADIANCEHTN SOLO):a multicentre, international, single-blind,randomised, sham-controlled trial. Lancet,2018,391(10137):2335-2345.
- [10] B?hm M,Kario K,Kandzari DE,et al. E fficacy of catheterbased renal denervation in the absence of antihypertensive medications(SPYRAL HTN-OFF MED pivotal):a multicentre, randomised, sham-controlled trial. Lancet,2020,395(10234):1444-1451.
- [11] Azizi M, Sanghvi K, Saxena M, et al. Ultrasound renal denervation for hypertension resistant to a triple medication pill(RADIANCE-HTN TRIO):a randomised, multicentre,single-blind, sham-controlled trial. Lancet,2021,397(10293):2476-2486.
- [12] Kario K, Hoshide S, Mizuno H, et al. Nighttime blood pressure phenotype and cardiovascular prognosis:practitionerbased nationwide jamp study. Circulation,2020,142(19):1810-1820.
- [13] Thomopoulos C, Parati G, Zanchetti A. Effects of blood pressure lowering on outcome incidence in hypertension. 1.Overview, meta-analyses, and meta-regression analyses of randomized trials. J Hypertens,2014,32(12):2285-2295.
- [14] Ettehad D, Emdin CA, Kiran A, et al. Blood pressure lowering for prevention of cardiovascular disease and death:a systematic review and meta-analysis. Lancet,2016,387(10022):957-967.
- [15] Blood Pressure Lowering Treatment Trialists Collaboration.Pharma-cological blood pressure lowering for primary and secondary preven-tion of cardiovascular disease across dif ferent levels of blood pressure:an individual participantlevel data meta-analysis. Lancet,2021,397(10285):1625-1636.
- [16] Pietzsch JB,Mahfoud F,Williams B,et al. Clinical event reductions in high-risk hypertension patients treated with renal denervation:a model-based estimate based on 36-month data from the global symplicity registry. J Am Coll Cardiol,2021,77(18 Supplement 1):1644.
- [17] Sanders MF, Reitsma JB, Morpey M, et al. Renal safety of catheter-based renal denervation:systematic review and Metaanalysis. Nephrol Dial Transplant,2017,32(9):1440-1447.
- [18] Azizi M, Daemen J, Lobo MD, et al. 12-month results from the unblinded phase of the radiance-htn solo trial of ultrasound renal denervation. JACC Cardiovasc Interv,2020,13(24):2922-2933.
- [19] Mahfoud F, Mancia G, Schmieder R, et al. Renal denervation in high-risk patients with hypertension. J Am Coll Cardiol,2020,75(23):2879-2888.
- [20] Templin C, Jaguszewski M, Ghadri JR, et al. Vascular lesions induced by renal nerve ablation as assessed by optical coherence tomography:pre and postprocedural comparison w i t h t h e s i m p l i c i t y c a t h e t e r s y s t e m a n d t h e e n l i g h t n multielectrode renal denervation catheter. Eur Heart J,2013,34(28):2141-2148.
- [21] Townsend RR, Walton A, Hettrick DA, et al. Review and meta-analysis of renal artery damage following percutaneous renal denervation with radiofrequency renal artery ablation.EuroIntervention,2020,16(1):89-96.
- [22] Schmieder RE, Mahfoud F, Azizi M, et al. European society of hypertension position paper on renal denervation 2018. J Hypertens,2018,36(10):2042-2048.
- [23] Lauder L, Azizi M, Kirtane AJ,et al. Device-based therapies for arterial hypertension. Nat Rev Cardiol,2020,17(10):614-628.
- [24] Gosse P, Cremer A, Pereira H, et al. Twenty-fourhour blood pressure monitoring to predict and assess impact of renal denervation:the denerhtn study(renal dener-vation for hypertension). Hypertension,2017,69(3):494-500.
- [25] Mahfoud F, Renkin J, Sievert H, et al. Alcohol-mediated renal denervation using the peregrine system infusion catheter for treatment of hypertension. JACC Cardiovasc Interv,2020,13(4):471-484.
- [26] Fengler K, Rommel KP, Blazek S, et al. A threearm randomized trial of dif ferent renal denervation devices and techniques in patients with resistant hypertension(radio-soundhtn).Circulation,2019,139(5):590-600.
- [27] Geisler BP, Egan BM, Cohen JT, et al. Cost-ef fectiveness and clinical ef fectiveness of catheter-based renal denervation for resistant hypertension. J Am Coll Cardiol,2012,60(14):1271-1277.
- [28] Mahfoud F, Galle J, Schunkert H, et al. Criteria of the German Society of Kardiology, Nephrology and Hypertension for the certification Renal Denervation Competence Center. Der Kardiologe,2021.[Epub ahead of print].
- [29] Schmieder RE, H?gerl K, Jung S, et al. Patient preference for therapies in hypertension:a cross-sectional survey of German patients. Clin Res Cardiol,2019,108(12):1331-1342.
- [30] Schmieder RE, Kandzari DE, Wang TD, et al. Dif ferences in patient and physician perspectives on pharmaceutical therapy and renal denervation for the management of hypertension. J Hypertens,2021,39(1):162-168.
- [31] Doumas M, Andreadis E, Andronoglou M, et al. Joint esh excellence centers’ national meeting on renal sympathetic denervation:a Greek experts’ survey. Hellenic J Cardiol,2021.[Epub ahead of print].