4.7 Review

International Expert Consensus Statement Percutaneous Transluminal Renal Denervation for the Treatment of Resistant Hypertension

期刊

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
卷 62, 期 22, 页码 2031-2045

出版社

ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2013.08.1616

关键词

renal denervation; resistant hypertension; sympathetic

资金

  1. Medtronic
  2. National Health and Medical Research Council
  3. Medtronic Ardian
  4. Abbott
  5. Novartis
  6. Servier
  7. Boehringer Ingelheim
  8. Forest Labs
  9. Takeda
  10. St. Jude Medical
  11. Cordis
  12. Biosense Webster
  13. Foundation for Polish Science [KOLUMB/2010-1]
  14. Deutsche Hochdruckliga
  15. Deutsche Forschungsgemeinschaft
  16. Covidien
  17. Kona Medical
  18. British Heart Foundation [FS/10/38/28268] Funding Source: researchfish
  19. Medical Research Council [MC_PC_13090] Funding Source: researchfish
  20. National Institute for Health Research [NF-SI-0509-10222] Funding Source: researchfish
  21. MRC [MC_PC_13090] Funding Source: UKRI

向作者/读者索取更多资源

Catheter-based radiofrequency ablation technology to disrupt both efferent and afferent renal nerves has recently been introduced to clinical medicine after the demonstration of significant systolic and diastolic blood pressure reductions. Clinical trial data available thus far have been obtained primarily in patients with resistant hypertension, defined as standardized systolic clinic blood pressure >= 160 mm Hg (or >= 150 mm Hg in patients with type 2 diabetes) despite appropriate pharmacologic treatment with at least 3 antihypertensive drugs, including a diuretic agent. Accordingly, these criteria and blood pressure thresholds should be borne in mind when selecting patients for renal nerve ablation. Secondary forms of hypertension and pseudoresistance, such as nonadherence to medication, intolerance of medication, and white coat hypertension, should have been ruled out, and 24-h ambulatory blood pressure monitoring is mandatory in this context. Because there are theoretical concerns with regard to renal safety, selected patients should have preserved renal function, with an estimated glomerular filtration rate >= 45 ml/min/1.73 m(2). Optimal periprocedural management of volume status and medication regimens at specialized and experienced centers equipped with adequate infrastructure to cope with potential procedural complications will minimize potential patient risks. Long-term safety and efficacy data are limited to 3 years of follow-up in small patient cohorts, so efforts to monitor treated patients are crucial to define the long-term performance of the procedure. Although renal nerve ablation could have beneficial effects in other conditions characterized by elevated renal sympathetic nerve activity, its potential use for such indications should currently be limited to formal research studies of its safety and efficacy. (J Am Coll Cardiol 2013; 62: 2031-45) (C) 2013 by the American College of Cardiology Foundation

作者

我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。

评论

主要评分

4.7
评分不足

次要评分

新颖性
-
重要性
-
科学严谨性
-
评价这篇论文

推荐

暂无数据
暂无数据