Guber Kenneth, Kirtane Ajay J
Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA.
Division of Cardiology, Columbia University Irving Medical Center/NewYork-Presbyterian Hospital, New York, New York, USA.
Kidney Int Rep. 2022 Jul 14;7(10):2129-2140. doi: 10.1016/j.ekir.2022.06.019. eCollection 2022 Oct.
Arterial hypertension is the most prevalent global modifiable risk factor for cardiovascular morbidity and mortality. Despite the availability of numerous pharmacologic treatments, many patients do not achieve guideline-recommended blood pressure targets. Therefore, renal sympathetic denervation (RDN), a process in which catheter-directed techniques are used to ablate portions of the renal artery to reduce sympathetic activity, has been extensively investigated as a complementary and nonpharmacologic approach for the treatment of arterial hypertension. This review seeks to discuss the pathophysiological rationale of this strategy, to survey its history and development, and to highlight the current clinical evidence and possible future directions of its employment. In sum, RDN has demonstrated itself to be a safe and well-tolerated endovascular intervention that can reliably contribute to improved blood pressure control and, perhaps ultimately, significant cardiovascular prognosis.
动脉高血压是全球范围内导致心血管疾病发病和死亡的最普遍的可改变风险因素。尽管有多种药物治疗方法，但许多患者并未达到指南推荐的血压目标。因此，肾交感神经去支配术（RDN），即一种使用导管导向技术消融部分肾动脉以降低交感神经活性的过程，已作为治疗动脉高血压的一种补充性非药物方法得到广泛研究。本综述旨在讨论该策略的病理生理原理，回顾其历史和发展，并强调其目前的临床证据以及未来可能的应用方向。总之，肾交感神经去支配术已证明自身是一种安全且耐受性良好的血管内干预措施，能够可靠地有助于改善血压控制，并且或许最终能显著改善心血管预后。
