Long-term outcomes following radiofrequency renal denervation: meta-analysis of 18 reports

作者：Felix Mahfoud, David E. Kandzari, Markus P. Schlaich, Roland E Schmieder, Lucas Lauder, Luís M. Ruilope, Krzysztof Narkiewicz, Bryan Williams, Douglas A. Hettrick, Te‐Hsin Lung, Flavio Ribichini, Joachim Weil, Faisal Sharif, Giuseppe Mancia, Michael Böhm · 发表于：European Journal of Preventive Cardiology · 年份：2025 · DOI：10.1093/eurjpc/zwaf368 · 被引用次数：6 · 研究领域：Blood Pressure and Hypertension Studies、Chronic Kidney Disease and Diabetes、Diagnosis and Treatment of Venous Diseases

AIMS: Radiofrequency (RF) renal denervation (RDN) safely lowers office and 24-h blood pressure (BP). This meta-analysis examined the long-term durability of RF RDN based on randomized trials and observational studies. METHODS AND RESULTS: Patients with uncontrolled hypertension undergoing RF RDN using the Symplicity Flex™ or Spyral™ device and a minimum follow-up of 3 years were included. Key outcomes included office and 24-h BP change from baseline as well as changes in anti-hypertensive drugs. A random effects meta-analysis was conducted over 3 years, or the last reported follow-up beyond 3 years. A total of 2212 patients identified among 18 reports were evaluated for BP. The mean duration of follow-up was 4.4 years (range 3-9.4). The long-term reduction in office systolic BP from baseline in 15 reports (n = 2040) was -23.0 mmHg (95% confidence interval: -26.8 to -19.1, P < 0.05) for the random effects model and -20.5 (-21.6 to -19.4) for the fixed effect model. Twenty-four-hour ambulatory systolic BP was available in 11 reports (n = 1018) and decreased significantly by -13.6 mmHg (-16.5 to -10.8, P < 0.05). Fixed effect model results were similar. Diastolic office and 24-h BP paralleled these findings in both models. Nighttime systolic BP also decreased significantly by -14.2 mmHg (-27.6 to -0.8, P < 0.05). The number of prescribed anti-hypertensive drugs and eGFR also decreased. Heart rate remained unchanged through the final follow-up in both models. Safety events were r...