Kim Chan Joon, Chang Kiyuk, Kim Byeong Keuk, Park Chang Gyu, Jang Yangsoo
Division of Cardiology, Department of Internal Medicine, Uijeongbu St. Mary's Hospital, The Catholic University of Korea College of Medicine, Uijeongbu, Korea.
Department of Cardiology, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
Korean Circ J. 2021 Jan;51(1):43-55. doi: 10.4070/kcj.2020.0391.
DENEX™ is a novel renal sympathetic denervation (RDN) system that is equipped with 3 electrodes that deliver radiofrequency energy to the renal nerves along renal arteries. The purpose of this study was to evaluate the safety and efficacy of RDN with DENEX™ in resistant hypertension.
This was an open-label, single-arm, multicenter, first-in-man pilot study. Between November 2016 and May 2018, a total of 16 patients were enrolled at 4 centers in South Korea. The inclusion criteria were systolic blood pressure (SBP) ≥150 mmHg and use of 3 or more antihypertensive medications, including diuretics. The primary objective was the safety outcome of RDN with the DENEX™ system. The secondary objective was efficacy outcome based on changes of office, and 24-hour ambulatory SBP from baseline to 3 months. The patients underwent abdominal computed tomography (CT) or duplex ultrasonogram before and 6 months after RDN.
No major adverse events occurred after RDN for 6 month of follow-up period. There was no vascular complication either by CT or duplex ultrasonogram. The office SBP was significantly reduced from 164.6±11.6 mmHg at baseline to 142.0±20.4 mmHg (-24.4±24.4 mmHg, p=0.003) at 3 months. The ambulatory SBP was reduced from 151.44±12.85 mmHg at baseline to 140.0±16.5 mmHg (-13.1±18.9 mmHg, p=0.056) at 3 months.
RDN with the DENEX™ system showed a favorable safety profile in resistant hypertension. A significant reduction in office SBP and a borderline reduction in ambulatory SBP were observed.
ClinicalTrials.gov Identifier: NCT04248530.
DENEX™是一种新型肾交感神经去神经支配(RDN)系统,配备有3个电极,可沿肾动脉向肾神经输送射频能量。本研究的目的是评估使用DENEX™进行RDN治疗难治性高血压的安全性和有效性。
这是一项开放标签、单臂、多中心的人体首次试点研究。2016年11月至2018年5月期间,韩国4个中心共纳入了16例患者。纳入标准为收缩压(SBP)≥150 mmHg且使用3种或更多抗高血压药物,包括利尿剂。主要目标是使用DENEX™系统进行RDN的安全性结果。次要目标是基于诊室血压以及从基线到3个月的24小时动态SBP变化的有效性结果。患者在RDN术前和术后6个月接受腹部计算机断层扫描(CT)或双功超声检查。
在6个月的随访期内,RDN术后未发生重大不良事件。CT或双功超声检查均未发现血管并发症。诊室SBP从基线时的164.6±11.6 mmHg显著降至3个月时的142.0±20.4 mmHg(-24.4±24.4 mmHg,p=0.003)。动态SBP从基线时的151.44±12.85 mmHg降至3个月时的140.0±16.5 mmHg(-13.1±18.9 mmHg,p=0.056)。
使用DENEX™系统进行RDN在难治性高血压中显示出良好的安全性。观察到诊室SBP显著降低,动态SBP有临界值降低。
ClinicalTrials.gov标识符:NCT04248530。