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慢性心力衰竭患者规范化药物治疗基础上行去肾神经术的疗效

The effect of renal denervation on patients with heart failure treated by guideline-directed management and therapy
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摘要 目的探讨去肾神经术(renal denervation,RDN)能否在指南推荐的药物治疗(guideline-directed management and therapy,GDMT)基础上进一步改善慢性心力衰竭(heart failure,HF)患者的左室射血分数(left ventricular ejection fraction,LVEF)。方法回顾性选择2023年1月1日至2024年8月31日因HF于重庆医科大学附属第二医院行RDN的扩张型心肌病(dilated cardiomyopathy,DCM)患者,所有患者术前均接受至少3个月以上的GDMT但LVEF仍低于55%。通过对比基线、GDMT期间、RDN后的经胸壁超声心动图(transthoracic echocardiography,TTE)结果,分析RDN能否在GDMT的基础上进一步提高患者的LVEF。结果共纳入7例诊断为DCM的HF患者,平均年龄(52.86±9.86)岁,男性5例(71.4%),基线LVEF 34.86%±10.22%。经过平均(9.29±8.06)个月的GDMT后,LVEF显著升高(44.57%±5.59%,P=0.024)。行RDN后3个月后随访显示,LVEF进一步显著改善(54.43%±9.05%,P=0.026)。RDN后平均随访(11.00±4.12)个月,LVEF仍保持稳定(54.86%±7.10%,P=0.805),没有患者出现不良事件。结论RDN可以在GDMT的基础上进一步提高HF患者的LVEF。 Objective To explore whether renal denervation(RDN)could improve the left ventricular ejection fraction(LVEF)of patients with heart failure(HF)on the basis of guideline-directed management and therapy(GDMT).Methods From January 1,2023 to August 31,2024,HF patients diagnosed as dilated cardiomyopathy(DCM)who underwent RDN in the Second Affiliated Hospital of Chongqing Medical University were retrospectively enrolled,all patients had received GDMT for at least three months but the LVEF remained below 55%.Parameters of transthoracic echocardiography(TTE)at baseline,during GDMT,and after RDN were compared to analyze whether RDN can further improve the LVEF of patients on the basis of GDMT.Results A total of 7 HF patients diagnosed with DCM were enrolled,the mean age was(52.86±9.86)years old,and 5(71.4%)were male.After an average of(9.29±8.06)months of GDMT,LVEF significantly increased from baseline(34.86%±10.22%)to(44.57%±5.59%,P=0.024).Three months after RDN,LVEF was further significantly improved(54.43%±9.05%,P=0.026).The average follow-up after RDN was(11.00±4.12)months.The LVEF remained stable(54.86%±7.10%,P=0.805),and no adverse events occurred in the patients.Conclusions RDN can further enhance the LVEF of HF patients on the basis of GDMT.
作者 肖明阳 杨仙 匡雪 陈文江 杨杰 殷跃辉 XIAO Mingyang;YANG Xian;KUANG Xue;CHEN Wenjiang;YANG Jie;YIN Yuehui(Department of Cardiology,the Second Affiliated Hospital of Chongqing Medical University,Chongqing 400010,China)
机构地区 重庆医科大学附属第二医院心血管内科
出处 《中国临床医学》 2025年第6期953-959,共7页 Chinese Journal of Clinical Medicine
基金 重庆市“英才计划”项目(13-002-001)。
关键词 去肾神经术 心力衰竭 扩张型心肌病 左室射血分数 renal denervation heart failure dilated cardiomyopathy left ventricular ejection fraction
分类号 R541.6 [医药卫生—心血管疾病]
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中国临床医学
2025年 第6期

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