在抗高血压患者中对不同神器设备和技术进行三臂随机试验 (RADIOSOUND-HTN)
Karl Fengler1, Karl-Philipp Rommel1, Stephan Blazek1
1Department of Cardiology, Heart Center Leipzig at University of Leipzig, Germany (K.F., K.-P.R., S.B., C.B., P.H., M.v.R., S.W., S.D., H.T., P.L.).
Circulation
|December 28, 2018
概括
基于超声波的交神经退化 (RDN) 显著降低了血压,远高于针对抗高血压患者的主要动脉的射频RDN. 综合射频RDN没有显示出优异的结果.
科学领域:
- 心血管医学
- 干预心脏病学
- 高血压管理
背景情况:
- 抗药性高血压是一个重大的临床挑战.
- 使用射频 (RF) 和超声波技术的内血管交感消毒 (RDN) 显示出有效性.
- 射频和超声波RDN之间的直接比较是有限的.
研究的目的:
- 对抗高血压患者的内血管超声基RDN与RF基RDN的疗效进行比较.
- 评估不同的RF RDN策略:主要脏动脉与主要动脉加分支.
- 确定3个月内静心白天门诊血压变化的主要终点.
主要方法:
- 在120名耐高血压患者中比较了三种RDN策略的随机对比试验.
- 第一个组:主要动脉的RF RDN.
- 第二组:主要动脉,侧枝和附属的RF RDN.
- 第三组:主要动脉的基于超声波的RDN
主要成果:
- 所有的RDN疗法都能降低3个月的系统性白天门诊血压.
- 超声波RDN显示血压降低显著高于仅主要脏动脉的RFRDN (-13.2 mmHg对比 - 6.5 mmHg).
- 在两种RF RDN策略之间或在超声波RDN和联合RF RDN方法之间没有观察到血压降低的显著差异.
结论:
- 基于内血管超声波的RDN优于仅针对主要脏动脉的RFRDN.
- 包括侧枝和附件在内的综合RF RDN方法与单独向主动脉相比没有更好的结果.
- 超声波RDN是治疗高血压的一个有希望的替代方案.
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