Efficiency and safety of catheter-based renal denervation for chronic heart failure: Meta-analysis
10.13929/j.1672-8475.201812049
- Author:
Baibing GOU
1
Author Information
1. Department of Cardiology, The Second Affiliated Hospital of Chongqing Medical University
- Publication Type:Journal Article
- Keywords:
Catheter-based renal denervation;
Heart failure;
Meta-analysis;
Safety;
Treatment outcome
- From:
Chinese Journal of Interventional Imaging and Therapy
2019;16(6):342-348
- CountryChina
- Language:Chinese
-
Abstract:
Objective: To evaluate the efficacy and safety of catheter-based renal denervation (RDN) for chronic heart failure using Meta-analysis. Methods: Literature about catheter-based RDN for chronic heart failure were searched in Cochrane Library, PubMed, EMBASE, CNKI and Wanfang databases from the establishment of databases to Dec. 2018 for Meta-analysis after screening. The primary outcome indexes included left ventricular ejection fraction (LVEF), left ventricular end systolic diameter (LVDD) and brain natriuretic peptide (BNP), and the secondary outcome indexes included heart rate, systolic and diastolic blood pressures as well as the results of 6 min walk test. Data processing were performed using Rev Man 5. 3 software. The effect size was expressed as weighted mean difference (WMD) or standardized mean difference (SMD) and the 95% confidence interval (CI). For randomized controlled trials (RCT) and cohort studies (CS), the changes of outcomes were analyzed based on RDN group and drug-treated group, while for self-controlled trials were analyzed based on pre-treatment and post-treatment outcomes. Results: A total of 8 studies involved 230 patients were finally included. In RCT/CS, LVEF of RDN group significantly increased than that of drug-treated group (weighted mean difference WMD=7.17, 95%CI [3.77, 10.56], P<0.01), while another primary outcome indexes including LVDD (WMD=-4.42, 95%CI [-0.59, 0.26], P<0.01) and BNP (SMD=-1.48, 95%CI [2.38, -1.12], P<0.01) significantly decreased. Compared with drug-treated group, the heart rate of RDN group significantly decreased (WMD=-9.96, 95%CI [-17.08, -2.12, P=0.01]), while the systolic blood pressure significantly increased (WMD=12.89, 95%CI [1.15, 24.17], P=0.27). And there was no statistic difference of diastolic blood pressure nor the results of 6 min walk test between RDN and drug-treated groups (all P>0.05). In self-controlled trials, BNP significantly increased (SMD=-0.47, 95%CI [-0.83, 0.11], P=0.01), while the heart rate significantly decreased (WMD=-2.57, 95%CI [-4.75, -0.39], P=0.02) after RDN. No statistic difference of another outcome indexes was found before and after RDN treatment (all P>0.05). Conclusion: Catheter-based RDN can significantly improve cardiac function in patients with chronic heart failure.
