Περίληψη:
Background: Renal sympathetic denervation (RDN) is a safe device-based
option for the treatment of hypertension although current guidelines do
not recommend its use in routine clinical practice. In this
meta-analysis, we investigated the effects of RDN in cardiac magnetic
resonance (CMR)-derived cardiac indices.
Methods: This meta-analysis was performed in accordance with the PRISMA
statement. A comprehensive systematic search of MEDLINE database and
Cochrane library through to January 2021 was performed. The inclusion
criteria were studies that enrolled patients undergoing RDN in whom CMR
data were provided for left ventricular end-diastolic volume indexed to
body surface area (BSA) (LVEDVI), left ventricular end-systolic volume
indexed (LVESVI), left ventricular mass indexed (LVMI), and left
ventricular ejection fraction (LVEF) pre and post RDN. A random effects
model was used for the analyses.
Results: Our search strategy revealed 9 studies that were finally
included in the meta-analysis (n = 300 patients, mean age: 60 years old,
males: 59%). Compared to control group, RDN patients showed
significantly lower values in the attained volumes (LVEDVI:-6.70
ml/m(2), p = 0.01; LVESVI:-3.63 ml/m(2), p = 0.006). Moreover, RDN group
achieved a statistically significant higher attained LVEF (3.49%, p =
0.01). A non-significant difference was found in the attained LVMI
between RDN and control groups (-2.59 g/m(2), p = 0.39). Compared to
pre-RDN values, RDN reduces significantly the LVMI, the LVEDVI, and the
LVESVI while a non-significant change of LVEF was found.
Conclusions: In conclusion, the current study demonstrates the potential
beneficial role of RDN in CMRderived cardiac indices that reflect
adverse remodeling. However, large, randomized studies are needed to
elucidate the role of RDN in cardiac remodeling in hypertension, heart
failure, and other clinical settings. (C) 2021 Japanese College of
Cardiology. Published by Elsevier Ltd. All rights reserved.
Συγγραφείς:
Bazoukis, George
Thomopoulos, Costas
Tse, Gary
Vassiliou,
Vassilios S.
Liu, Tong
Dimitriadis, Kyriakos
Tatakis, Fotios
and Konstantinou, Konstantinos
Doumas, Michael
Tsioufis,
Konstantinos
