Department of Cardiology, Westmead Hospital, Sydney, New South Wales, Australia.
Sydney Medical School, University of Sydney, Sydney, New South Wales, Australia.
Catheter Cardiovasc Interv. 2019 Feb 15;93(3):E105-E111. doi: 10.1002/ccd.28038. Epub 2018 Dec 14.
To assess the clinical efficacy of renal artery denervation (RAD) in our center and to compare the efficacy of two different radiofrequency (RF) systems.
Several systems are available for RF renal denervation. Whether there is a difference in clinical efficacy among various systems remains unknown.
Renal artery denervation was performed on 43 patients with resistant hypertension using either the single electrode Symplicity Flex (n = 20) or the multi-electrode EnligHTN system (n = 23). Median post-procedural follow-up was 32.93 months. The primary outcome was post-procedural change in office blood pressure (BP) within 1 year (short-term follow-up). Secondary outcomes were change in office BP between 1 and 4 years (long-term follow-up) and the difference in office BP reduction between the two systems at each follow-up period.
For the total cohort, mean baseline office BP (systolic/diastolic) was 174/94 mmHg. At follow-up, mean changes in office BP from baseline were -19.70/-11.86 mmHg (P < 0.001) and -21.90/-13.94 mmHg (P < 0.001) for short-term and long-term follow-up, respectively. The differences in office BP reduction between Symplicity and EnligHTN groups were 8.96/1.23 mmHg (P = 0.42 for systolic BP, P = 0.83 for diastolic BP) and 9.56/7.68 mmHg (P = 0.14 for systolic BP, P = 0.07 for diastolic BP) for short-term and long-term follow-up, respectively.
In our cohort, there was a clinically significant office BP reduction after RAD, which persisted up to 4 years. No significant difference in office BP reduction between the two systems was found.
评估本中心肾动脉去神经支配（RAD）的临床疗效，并比较两种不同射频（RF）系统的疗效。
有几种系统可用于 RF 肾去神经支配。不同系统之间的临床疗效是否存在差异尚不清楚。
对 43 例难治性高血压患者进行肾动脉去神经支配，使用单电极 Symplicity Flex（n=20）或多电极 EnligHTN 系统（n=23）。中位术后随访时间为 32.93 个月。主要结局为术后 1 年内（短期随访）诊室血压（BP）的变化。次要结局为 1 至 4 年（长期随访）诊室 BP 的变化以及两种系统在每个随访期诊室 BP 降低的差异。
对于总队列，平均基线诊室 BP（收缩压/舒张压）为 174/94mmHg。随访时，与基线相比，诊室 BP 的平均变化分别为-19.70/-11.86mmHg（P<0.001）和-21.90/-13.94mmHg（P<0.001），分别为短期和长期随访。Symplicity 和 EnligHTN 组诊室 BP 降低的差异分别为 8.96/1.23mmHg（收缩压 P=0.42，舒张压 P=0.83）和 9.56/7.68mmHg（收缩压 P=0.14，舒张压 P=0.07），分别为短期和长期随访。
在本队列中，RAD 后诊室 BP 显著降低，持续至 4 年。两种系统之间诊室 BP 降低的差异无统计学意义。
