Klinik für Innere Medizin III, Kardiologie, Angiologie und Internistische Intensivmedizin, Universitätsklinikum des Saarlandes, Homburg/Saar, Germany.
Int J Cardiol. 2013 Sep 10;167(6):2846-51. doi: 10.1016/j.ijcard.2012.07.027. Epub 2012 Aug 20.
Renal sympathetic denervation (RDN) reduces sympathetic activity and blood pressure (BP) in patients with resistant hypertension. The present study aimed to investigate the effects of RDN on HR and other electrocardiographic parameters.
136 patients aged 62.2 ± 0.8 years (58% male, BP 177 ± 2/93 ± 1 mmHg) with resistant hypertension underwent RDN. BP and a 12-lead electrocardiogram (ECG) were recorded before, 3 months (n=127), and 6 months (n=88) after RDN.
After 3 months (3M) and 6 months (6M), systolic BP was reduced by 25.5 ± 2.4 mmHg (p<0.0001) and 28.1 ± 3 mmHg (p<0.0001). HR at baseline was 66.1 ± 1 beats per minute (bpm) and was reduced by 2.6 ± 0.8 bpm after 3 months (p=0.001) and 2.1 ± 1.1 bpm after 6 months (p=0.046). Patients with HR at baseline between 60-71 bpm and ≥ 71 bpm had a reduction of 2.9 ± 7.6 bpm (p=0.008) and 9.0 ± 8.6 bpm (p<0.0001), respectively, whereas in patients with baseline HR<60 bpm HR slightly increased after 3 months (2.7 ± 8.4 bpm; p=0.035). Neither baseline HR nor change of HR correlated with the reduction of systolic BP. The PR interval was prolonged by 11.3 ± 2.5 ms (p<0.0001) and 10.3 ± 2.5 ms (p<0.0001) at 3 and 6 months after RDN, respectively.
Renal sympathetic denervation reduced heart rate and the PR interval as indicators of cardiac autonomic activity.
肾去交感神经术(RDN)可降低高血压患者的交感神经活性和血压(BP)。本研究旨在探讨 RDN 对心率(HR)和其他心电图参数的影响。
136 名年龄 62.2±0.8 岁(58%为男性,BP 为 177±2/93±1mmHg)的难治性高血压患者接受 RDN 治疗。在 RDN 前、3 个月(n=127)和 6 个月(n=88)时,记录 BP 和 12 导联心电图(ECG)。
在 3 个月(3M)和 6 个月(6M)时,收缩压分别降低了 25.5±2.4mmHg(p<0.0001)和 28.1±3mmHg(p<0.0001)。基础 HR 为 66.1±1 次/分钟(bpm),3 个月后降低了 2.6±0.8bpm(p=0.001),6 个月后降低了 2.1±1.1bpm(p=0.046)。基础 HR 在 60-71bpm 和≥71bpm 的患者,分别降低了 2.9±7.6bpm(p=0.008)和 9.0±8.6bpm(p<0.0001),而基础 HR<60bpm 的患者在 3 个月后 HR 略有增加(2.7±8.4bpm;p=0.035)。基础 HR 或 HR 变化均与收缩压的降低无关。RDN 后 3 个月和 6 个月时,PR 间期分别延长了 11.3±2.5ms(p<0.0001)和 10.3±2.5ms(p<0.0001)。
肾去交感神经术降低了心率和 PR 间期,作为心脏自主活动的指标。