[1]吴美桦,郜俊清.肺静脉隔离术联合肾动脉去交感神经术临床治疗心房颤动meta分析[J].介入放射学杂志,2021,30(01):9-13.
 WU Meihua,GAO Junqing..Pulmonary vein isolation combined with renal artery denervation for the treatment of atrial fibrillation: a meta analysis[J].journal interventional radiology,2021,30(01):9-13.
点击复制

肺静脉隔离术联合肾动脉去交感神经术临床治疗心房颤动meta分析()

PDF下载中关闭

分享到:

《介入放射学杂志》[ISSN:1008-794X/CN:31-1796/R]

卷:
30
期数:
2021年01
页码:
9-13
栏目:
心脏介入
出版日期:
2021-01-25

文章信息/Info

Title:
Pulmonary vein isolation combined with renal artery denervation for the treatment of atrial fibrillation: a meta analysis
作者:
吴美桦 郜俊清
Author(s):
WU Meihua GAO Junqing.
Department of Cardiology, Putuo District Central Hospital, Shanghai 200062, China
关键词:
【关键词】 心房颤动 复发 肺静脉隔离术 肾动脉去交感神经术
文献标志码:
A
摘要:
【摘要】 目的 评价肺静脉隔离术(PVI)联合肾动脉去交感神经术(RDN)治疗心房颤动(房颤)的有效性。方法 计算机检索Pubmed、Cochrane Library、中国学术期刊(CNKI)、万方和维普等数据库2009年1月至2020年2月收录的PVI联合RDN治疗房颤的临床随机对照研究文献。采用RevMan 5.3软件进行meta分析。结果 纳入6篇临床随机对照试验研究文献共654例患者。Meta分析结果显示,术后12个月接受PVI联合RDN治疗组房颤患者房颤复发风险与单纯PVI治疗组(对照组)相比显著降低(OR=0.40,95%CI=0.29~0.56,P<0.000 1);诊室血压平均收缩压与对照组相比降低12.21 mmHg(1 mmHg=0.133 kPa,95%CI=-12.22~-12.21,P<0.000 1),平均舒张压降低8.84 mmHg(95%CI=-8.84~-8.83,P<0.000 1);动态血压平均收缩压与对照组相比下降3.37 mmHg(95%CI=-3.38~-3.35,P<0.000 1),平均舒张压降低1.38 mmHg(95%CI=-1.40~-1.37,P<0.000 1)。 结论 PVI 联合RDN治疗房颤患者与单纯PVI治疗相比,有更低的房颤复发率,且可降低患者血压。

参考文献/References:

[1] Linz D, Elliott AD, Hohl M, et al. Role of autonomic nervous system in atrial fibrillation[J]. Int J Cardiol, 2019, 287: 181- 188.
[2] 吴 杰.自主神经异常与心房颤动[J]. 诊断学理论与实践, 2015, 14:208- 210.
[3] Weber MA, Mahfoud F, Schmieder RE, et al. Renal denervation for treating hypertension: current scientific and clinical evidence[J]. JACC Cardiovasc Interv, 2019, 12: 1095- 1105.
[4] Schlaich MP, Schmieder RE, Bakris G, et al. International expert consensus statement: percutaneous transluminal renal denervation for the treatment of resistant hypertension[J]. J Am Coll Cardiol, 2013, 62: 2031- 2045.
[5] 朱清一, 彭 文,柴湘平, 等. 肾交感神经导管消融术治疗难治性高血压临床研究进展[J]. 介入放射学杂志, 2012, 21:692- 695.
[6] 杨 宁,程康安,李拥军. 去肾交感神经支配术与高血压[J]. 介入放射学杂志, 2012, 21:441- 446.
[7] Feyz L, Theuns DA, Bhagwandien R, et al. Atrial fibrillation reduction by renal sympathetic denervation: 12 months’ results of the AFFORD study[J]. Clin Res Cardiol, 2019, 108: 634- 642.
[8] Higgins JT, Thompson SG. Quantifying heterogeneity in a meta- analysis[J]. Stat Med, 2002, 21: 1539- 1558.
[9] Steinberg JS, Shabanov V, Ponomarev D, et al. Effect of renal denervation and catheter ablation vs catheter ablation alone on atrial fibrillation recurrence among patients with paroxysmal atrial fibrillation and hypertension: the ERADICATE- AF randomized clinical trial[J]. JAMA, 2020, 323: 248- 255.
[10] Kiuchi MG, Chen S, E Silva GR, et al. Pulmonary vein isolation alone and combined with renal sympathetic denervation in chronic kidney disease patients with refractory atrial fibrillation[J]. Kidney Res Clin Pract, 2016, 35: 237- 244.
[11] Kiuchi MG, Chen S, E Silva GR, et al. The addition of renal sympathetic denervation to pulmonary vein isolation reduces recurrence of paroxysmal atrial fibrillation in chronic kidney disease patients[J]. J Interv Card Electrophysiol, 2017, 48: 215- 222.
[12] Pokushalov E, Romanov A, Corbucci G, et al. A randomized comparison of pulmonary vein isolation with versus without concomitant renal artery denervation in patients with refractory symptomatic atrial fibrillation and resistant hypertension[J]. J Am Coll Cardiol, 2012, 60: 1163- 1170.
[13] Romanov A, Evgeny P, Ponomarev D, et al. Pulmonary vein isolation with concomitant renal artery denervation is associated with reduction in both arterial blood pressure and atrial fibrillation burden: data from implantable cardiac monitor[J]. Cardiovasc Ther, 2017, 35: e12264.
[14] Kiuchi MG, Chen J, Hoye NA. Pulmonary vein isolation combined with spironolactone or renal sympathetic denervation in patients with chronic kidney disease, uncontrolled hypertension, paroxysmal atrial fibrillation, and a pacemaker[J]. J Interv Card Electrophysiol, 2018, 51: 51- 59.
[15] Yu L, Huang B, Wang Z, et al. Impacts of renal sympathetic activation on atrial fibrillation: the potential role of the autonomic cross talk between kidney and heart[J]. J Am Heart Assoc, 2017, 6: e004716.
[16] Zhao Q, Yu S, Zou M, et al. Effect of renal sympathetic denervation on the inducibility of atrial fibrillation during rapid atrial pacing[J]. J Interv Card Electrophysiol, 2012, 35: 119- 125.
[17] Wang X, Zhao Q, Deng H, et al. Effects of renal sympathetic denervation on the atrial electrophysiology in dogs with pacing- induced heart failure[J]. Pacing Clin Electrophysiol, 2014, 37: 1357- 1366.
[18] Wang X, Zhao Q, Huang H, et al. Effect of renal sympathetic denervation on atrial substrate remodeling in ambulatory canines with prolonged atrial pacing[J]. PLoS One, 2013, 8: e64611.
[19] Wang X, Huang C, Zhao Q, et al. Effect of renal sympathetic denervation on the progression of paroxysmal atrial fibrillation in canines with long- term intermittent atrial pacing[J]. Europace,2015, 17:647- 654.
[20] Huang B, Yu L, Scherlag BJ, et al. Left renal nerves stimulation facilitates ischemia- induced ventricular arrhythmia by increasing nerve activity of left stellate ganglion[J]. J Cardiovasc Electro-physiol, 2014, 25: 1249- 1256.
[21] Wei Y, Xu J, Zhou G, et al. Renal denervation suppresses the inducibility of atrial fibrillation in a rabbit model for atrial fibrosis[J]. PLoS One, 2016, 11: e0160634.
[22] 邹明辉,赵庆彦,于胜波,等. 肾去交感神经对心房快速刺激诱发心房颤动的影响[J]. 中华医学杂志, 2012, 92:2868- 2871.
[23] De Becker B, Van de Borne P. Treatment of hypertension to prevent atrial fibrillation[J]. Curr Pharm Des, 2019, 24: 4397- 4403.
[24] Wilson S, Kistler P, McLellan AJ, et al. Renal denervation and pulmonary vein isolation in patients with drug resistant hypertension and symptomatic atrial fibrillation[J]. J Atr Fibrillation, 2014, 7: 1165.
[25] Krum H, Schlaich MP, Sobotka PA, et al. Percutaneous renal denervation in patients with treatment- resistant hypertension: final 3- year report of the Symplicity HTN- 1 study[J]. Lancet, 2014, 383: 622- 629.
[26] Esler MD, Bohm M, Sievert H, et al. Catheter- based renal denervation for treatment of patients with treatment- resistant hypertension: 36 month results from the SYMPLICITY HTN- 2 randomized clinical trial[J]. Eur Heart J, 2014, 35: 1752- 1759.
[27] Krum H, Schlaich M, Whitbourn R, et al. Catheter- based renal sympathetic denervation for resistant hypertension: a multicentre safety and proof- of- principle cohort study[J]. Lancet, 2009, 373: 1275- 1281.
[28] Bakris GL, Townsend RR, Flack JM, et al. 12- month blood pressure results of catheter- based renal artery denervation for resistant hypertension: the SYMPLICITY HTN- 3 trial[J]. J Am Coll Cardiol, 2015, 65: 1314- 1321.
[29] Kandzari DE, Bohm M, Mahfoud F, et al. Effect of renal denervation on blood pressure in the presence of antihypertensive drugs: 6- month efficacy and safety results from the SPYRAL HTN- ON Med proof- of- concept randomised trial[J]. Lancet, 2018, 391: 2346-2355.
[30] Townsend RR, Mahfoud F, Kandzari DE, et al. Catheter- based renal denervation in patients with uncontrolled hypertension in the absence of antihypertensive medications(SPYRAL HTN- OFF Med):a randomised,sham- controlled,proof- of- concept trial[J]. Lancet, 2017, 390: 2160- 2170.

相似文献/References:

[1]杨熙章,吴纪瑞,杨永岩,等.灌注化疗预防肝癌术后复发[J].介入放射学杂志,1999,(02):32.
[2]许晓泉,施海彬,刘   圣,等. 外伤性颈动脉海绵窦瘘球囊栓塞术后复发危险因素分析及治疗[J].介入放射学杂志,2011,(12):931.
 XU Xiao-quan,SHI Hai-bin,LIU Sheng,et al.The analysis of risk factors and the treatment of recurrent traumatic carotid cavernous fistulas previously managed with detachable balloons[J].journal interventional radiology,2011,(01):931.
[3]顾俊鹏,顾 朋,迪力木拉提?巴吾东,等. 大咯血的介入治疗及复发的影响因素分析[J].介入放射学杂志,2012,(11):952.
 GU Jun? peng,GU Peng,DilimulatiBawudong,et al. The interventional management of massive hemoptysis and the analysis of factors influencing its recurrence[J].journal interventional radiology,2012,(01):952.
[4]胡 萍,司同国,郭 志.血清高迁移率族蛋白B1检测在T3N0M0期前列腺癌冷冻治疗后复发中的意义[J].介入放射学杂志,2013,(04):298.
 HU Ping,SI Tong? guo,GUO Zhi..The significance of serum HMGB1 in forecasting the recurrence of stage T3N0M0 prostate cancer after cryotherapy[J].journal interventional radiology,2013,(01):298.
[5]徐国斌,易广新,熊斌,等.原发性肝癌术后早期肝内复发转移36例的介入治疗[J].介入放射学杂志,2013,(04):325.
 XU Guo? bin,YI Guang? xin,XIONG Bin,et al.Interventional treatment of early intrahepatic recurrence or metastasis of primary liver carcinoma after surgical resection: initial experience of 36 cases[J].journal interventional radiology,2013,(01):325.
[6]顾佳宁,姜伟峰,周 立,等.瑞舒伐他汀对持续性心房颤动导管消融术后早期复发的影响[J].介入放射学杂志,2014,(10):848.
 GU Jia ning,JIANG Wei feng,ZHOU Li,et al.Evaluation of rosuvastatin in preventing early recurrence of persistent atrial fibrillation after catheter ablation treatment[J].journal interventional radiology,2014,(01):848.
[7]任国荣,姜 平,曹枭强,等. 基于CT的三维颈内动脉瘤手术前后的血流动力学分析[J].介入放射学杂志,2013,(10):825.
 REN Guo? rong,JIANG Ping,CAO Xiao? qiang,et al. Hemodynamic analysis of preoperative and postoperative carotid aneurysm by using CT 3- D numerical simulation[J].journal interventional radiology,2013,(01):825.
[8]宗迎迎,徐 浩,许 伟,等.经肝动脉化疗栓塞联合经皮微波消融序贯治疗早期肝癌的疗效及预后影响因素[J].介入放射学杂志,2015,(03):210.
 ZONG Ying ying,XU Hao,XU Wei,et al.Sequential therapy of TACE followed by percutaneous microwave coagulation for early stage primary hepatocellular carcinomas: curative effect and prognostic factors[J].journal interventional radiology,2015,(01):210.
[9]任 炜,杨 薇.射频消融治疗复发性肝癌疗效及预后因素分析[J].介入放射学杂志,2015,(10):923.
 REN Wei,YANG Wei.Radiofrequency ablation for the treatment of recurrent hepatocellular carcinoma: analysis of the therapeutic results and prognostic factors[J].journal interventional radiology,2015,(01):923.
[10]徐中琪,甘 伟,钱国军.复发性肝内胆管细胞癌治疗现状[J].介入放射学杂志,2016,(09):834.
 XU Zhong- qi,GAN Wei,QIAN Guo- jun.The treatment of recurrent intrahepatic cholangiocarcinomas: its present situation[J].journal interventional radiology,2016,(01):834.

备注/Memo

备注/Memo:
(收稿日期:2020- 05- 08)
(本文编辑:边 佶)
更新日期/Last Update: 2021-01-25