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Eur Heart J:未治疗的高血压患者基于导管的肾脏去神经支配术后动态心率降低

2019-01-05 xing.T MedSci原创

由此可见,与假手术患者相比,RDN患者的平均和最小早晨HR在3个月时显著降低。高于中位数的基线24小时HR可预测更大程度的血压降低,并且可以允许医生选择可能对该手术有反应的患者。

随机假手术对照SPYRAL HTN-OFF MED试验证明使用多电极导管的肾去神经支配(RDN)可降低非药物性高血压患者的动态血压(BP)。近日,血管领域权威杂志Eur Heart J上发表了一篇研究文章,目前的研究报告描述了RDN对该人群心率(HR)的影响。

该研究的患者诊室收缩压(SBP)≥150mmHg且<180mmHg,诊室舒张压(DBP)≥90mmHg,平均动态SBP≥140mmHg且<170mmHg。患者未进行药物或停止抗高血压药物治疗。80名患者按1:1的比例随机分配至RDN或假手术组。该事后分析评估了3个月RDN对HR和高基线24小时HR对BP和HR变化的影响。

在3个月时,与假手术组(-0.2 b.p.m.)相比,RDN组24小时HR(-2.5 b.p.m.)显著降低,P=0.003(协方差分析)。平均基线调整后的治疗差异在3个月时的平均早晨HR(-4.4 b.p.m.,P=0.046)和最小早晨HR(-3.0 b.p.m.,P=0.026)之间显著不同。基线24 h HR高于中位数(73.5 bpm)的RDN患者平均动态SBP(差异为-10.7 mmHg,P=0.001)和DBP(-7.5 mmHg,P<0.001)显著降低,而HRs低于中位数的RDN患者血压改变并不显著。

由此可见,与假手术患者相比,RDN患者的平均和最小早晨HR在3个月时显著降低。高于中位数的基线24小时HR可预测更大程度的血压降低,并且可以允许医生选择可能对该手术有反应的患者。

原始出处:

Michael Böhm,et al.Ambulatory heart rate reduction after catheter-based renal denervation in hypertensive patients not receiving anti-hypertensive medications: data from SPYRAL HTN-OFF MED, a randomized, sham-controlled, proof-of-concept trial.Eur Heart J.https://doi.org/10.1093/eurheartj/ehy871

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    2019-01-07 zhaojie88
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    2019-01-07 slcumt
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    2019-01-05 王秀

    学习了,涨知识了!

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