Effects of Renal Denervation on Cardiac Remodeling, Cardiac Function, and Cardiovascular Neurohormones in Heart Failure with Reduced Ejection Fraction Patients: A Meta-Analysis and Systematic Review.

IF 2.4 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiorenal Medicine Pub Date : 2025-03-25 DOI:10.1159/000545078

Fei Si, Qian Liu, Xin Ma, Jing Yu

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引用次数: 0

Abstract

Objective: To evaluate the effects of Renal Denervation (RDN) on cardiac remodeling, cardiac function, and cardiovascular (CV) neurohormones in heart failure patients with reduced ejection fraction (HFrEF).

Methods: We searched PubMed, Embase, Web of Science, and China National Knowledge Infrastructure (CNKI), identifying 6 randomized controlled trials (RCTs) and 9 single-arm studies, totaling 352 participants. Meta-analyses for RCTs and single-arm studies were conducted using STATA 17 software and the metafor package in R, respectively.

Results: In RCTs, RDN significantly reduced left ventricular end-diastolic diameter (LVEDD) (WMD=-3.55 mm, 95% CI [-5.51, -1.59], P<0.01), left ventricular end-systolic diameter (LVESD) (WMD=-4.13 mm, 95% CI [-6.08, -2.18], P<0.01), and significantly increased left ventricular ejection fraction (LVEF) (WMD=6.30%, 95% CI [4.64, 7.96], P<0.01) and 6-minute walk test (6MWT) distance (WMD=51.25 m, 95% CI [8.30, 94.20], P<0.05). brain natriuretic peptide (BNP) or N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels were significantly reduced (SMD=-1.24, 95% CI [-1.57, -0.90], P<0.01). In single-arm studies, RDN significantly reduced LVEDD (MC=-2.41 mm, 95% CI [-3.74, -1.09], P<0.01), LVESD (MC=-1.72 mm, 95% CI [-2.77, -0.67], P<0.01), LAD (MC=-1.62 mm, 95% CI [-3.16, -0.08], P<0.01), and interventricular septal thickness (IVST) (MC=-0.76mm, 95% CI [-1.05, -0.47], P<0.01). RDN significantly increased LVEF（MC=29.52%, 95% CI [ 12.74, 46.31], P<0.01）and 6MWT distance (MC=100.49 m, 95% CI [49.12, 151.86], P<0.05). RDN significantly reduced BNP or NT-proBNP levels (SMC=-0.57, 95% CI [-0.83, -0.31], P<0.01). Our study also found that RDN had varying degrees of reduction on Renin, Angiotensin II, Aldosterone, and Norepinephrine (NE) in HFrEF patients. Additionally, we found that RDN had no significant effect on SBP/DBP in HFrEF patients, but reduced heart rate (WMD=-7.22 bpm, 95% CI [-9.84, -4.60], P<0.01).

Conclusion: Our meta-analysis demonstrates that RDN can improve cardiac remodeling, enhance cardiac function, reduce CV neurohormones and has no significant effect on blood pressure in patients with HFrEF.

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肾去神经支配对心力衰竭伴射血分数降低患者心脏重塑、心功能和心血管神经激素的影响：荟萃分析和系统回顾。

目的：探讨肾去神经支配（RDN）对心力衰竭伴射血分数降低（HFrEF）患者心脏重构、心功能及心血管（CV）神经激素的影响。方法：检索PubMed、Embase、Web of Science和中国知网（CNKI），纳入6项随机对照试验（RCTs）和9项单臂研究，共352名受试者。分别使用STATA 17软件和R中的meta软件包对随机对照试验和单臂研究进行meta分析。结果：在rct中，RDN可显著降低左室舒张末期内径（LVEDD）（WMD=-3.55 mm, 95% CI [-5.51, -1.59], p）。结论：我们的meta分析表明，RDN可改善心脏重构，增强心功能，降低CV神经激素，对HFrEF患者血压无显著影响。

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来源期刊

Cardiorenal Medicine CARDIAC & CARDIOVASCULAR SYSTEMS-UROLOGY & NEPHROLOGY

CiteScore

5.40

自引率

2.60%

发文量

审稿时长

>12 weeks

期刊介绍： The journal ''Cardiorenal Medicine'' explores the mechanisms by which obesity and other metabolic abnormalities promote the pathogenesis and progression of heart and kidney disease (cardiorenal metabolic syndrome). It provides an interdisciplinary platform for the advancement of research and clinical practice, focussing on translational issues.