顽固性高血压患者肾去神经支配后左心室肥厚消退的性别差异

E. Sitkova, V. Mordovin, T. Ripp, S. Pekarskiy, T. Ryabova, А. Y. Falkovskaya, V. Lichikaki, I. Zyubanova, A. Baev, O. Mochula, V. Usov
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引用次数: 2

摘要

目的。目的探讨顽固性高血压(RH)患者肾去神经支配(RDN)术后左室肥厚(LVH)的消退情况。材料和方法。在签署知情同意书后,共有84名RH患者(50%为男性)入组研究。所有患者均行肾去神经手术。最初以及治疗后6个月和12个月,患者接受了仔细的检查。这些分析包括办公室血压(BP)测量、经胸超声心动图(TTE)研究以及左心室(LV)壁厚和左室质量(LVM)的评估,以及心脏磁共振(CMR)成像。结果。在办公室血压、年龄、服用降压药的数量和RDN射频能量应用的数量方面,男性和女性组具有可比性。由于解剖结构差异,男性组的LVM明显高于女性组。超声心动图数据显示,女性LVH发生率高于男性,差异无统计学意义:女性为90%,男性为76%,χ 2 = 0.079。根据超声心动图数据,在RND后1年,男性的心室壁厚度(4.4%)和LVM(9.5%)值显著回归,血压明显降低。根据CMR, RND后6个月LVM下降11.9%(0.039),12个月下降22.9%(0.026)。然而,在女性中没有发现明显的LVM变化。两组患者LVM的回归程度与RDN的降压作用无关。结论。LVH的发生频率在女性中不明显高于男性:女性为90%,男性为76%。RDN后1年,LVH在男性中显著消退,但在女性中无明显消退,且与血压降低程度无关。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Gender differences in left ventricular hypertrophy regression after renal denervation in patients with resistant hypertension
Purpose . To study the regression of left ventricular hypertrophy (LVH) in men and women with resistant hypertension (RH) after renal denervation (RDN). Material and Methods . A total of 84 patients (50% men) with RH were enrolled in the study after signing informed consent. Renal denervation was performed in all patients. Initially and at 6 and 12 months after treatment, patients underwent careful examination. These analyses included office blood pressure (BP) measurement, transthoracic echocardiography (TTE) study with assessments of the left ventricular (LV) wall thickness and LV mass (LVM), and cardiac magnetic resonance (CMR) imaging. Results. Groups of men and women were comparable in regard to office BP, age, number of administered antihypertensive drugs, and the number of radiofrequency energy applications for RDN. The LVM in the male group was significantly higher than in women due to anatomy differences. According to echocardiography data, the rate of LVH was insignificantly higher in women: 90% in women versus 76% in men, χ 2 = 0.079. In the presence of a significant and comparable BP reduction, significant regression in the values interventricular wall thickness (by 4.4%, р =0.039) and LVM (by 9.5%, р =0.044) was found in men one year after RND according to data of echocardiography. According to CMR according to CMR, LVM decreased by 11.9% at six months ( р =0.039) and by 22.9% at 12 months ( р =0.026) after RND. However, no significant changes in LVM were found in women. The extent of LVM regression did not depend on the antihypertensive effect of RDN in either group. Conclusion. The frequency of LVH was insignificantly higher in women than in men: 90% in women versus 76% in men. One year after RDN, LVH significantly regressed in men, but not in women, and did not depend on degree of BP reduction.
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