Gómez-Rosero Jaime A, Duque-González Laura, Senior-Sánchez Juan M
Departamento de Cardiología, Facultad de Medicina, Universidad CES, Medellín, Colombia.
Departamento de Cardiología, Hospital San Vicente Fundación Rionegro, Rionegro, Colombia.
Arch Cardiol Mex. 2024 Feb 15;94(3):366-372. doi: 10.24875/ACM.23000191.
This review provides an overview of the efficacy and safety of renal sympathetic denervation as a therapeutic approach for resistant hypertension. While the initial enthusiasm was sparked by the results of early clinical trials, it was dampened by the findings of the Symplicity HTN-3 study. However, recent advances in catheter technology and more refined patient selection criteria have yielded more promising results. Subsequent studies, such as SPYRAL HTN-OFF MED and RADIANCE II, demonstrated significant reductions in blood pressure, even in patients with mild to moderate hypertension. Despite the lack of robust data on major clinical outcomes, investigations into the time in therapeutic range for patients undergoing renal sympathetic denervation suggested potential cardiovascular benefits. Nevertheless, further research is needed to thoroughly understand the long-term impact, assess cost-effectiveness, and accurately identify which patient subgroups may derive the greatest benefits from this therapy.
本综述概述了肾交感神经去神经术作为难治性高血压治疗方法的疗效和安全性。虽然早期临床试验结果引发了最初的热情,但Symplicity HTN-3研究结果使其热情受挫。然而,导管技术的最新进展和更精细的患者选择标准产生了更有前景的结果。随后的研究,如SPYRAL HTN-OFF MED和RADIANCE II,表明即使是轻度至中度高血压患者,血压也有显著降低。尽管缺乏关于主要临床结局的有力数据,但对接受肾交感神经去神经术患者的治疗范围内时间的调查表明可能有心血管益处。尽管如此,仍需要进一步研究以全面了解其长期影响、评估成本效益,并准确确定哪些患者亚组可能从该治疗中获得最大益处。