The role of renal denervation in cardiology and beyond: An updated comprehensive review and future directives

医学 去神经支配 心脏病学 内科学 肾交感神经失神经 心力衰竭 血压 心房颤动 抵抗性高血压 交感神经切除术 重症监护医学
作者
Aman Goyal,Hritvik Jain,Amogh Verma,Jyoti Jain,Urooj Shamim,Sai Gautham Kanagala,Jatin Motwani,Rohit Chandra Dey,Zainali Chunawala,Amir Humza Sohail,Agastya D. Belur
出处
期刊:Current Problems in Cardiology [Elsevier BV]
卷期号:49 (2): 102196-102196 被引量:5
标识
DOI:10.1016/j.cpcardiol.2023.102196
摘要

Renal denervation (RDN) is a minimally invasive intervention performed by denervation of the nervous fibers in the renal plexus, which decreases sympathetic activity. These sympathetic nerves influence various physiological functions that regulate blood pressure (BP), including intravascular volume, electrolyte composition, and vascular tone. Although proven effective in some trials, controversial trials, such as the Controlled Trial of Renal Denervation for Resistant Hypertension (SYMPLICITY-HTN3), have demonstrated contradictory results for the effectiveness of RDN in resistant hypertension (HTN). In the treatment of HTN, individuals with primary HTN are expected to experience greater benefits compared to those with secondary HTN due to the diverse underlying causes of secondary HTN. Beyond its application for HTN, RDN has also found utility in addressing cardiac arrhythmias, such as atrial fibrillation, and managing cases of heart failure. Non-cardiogenic applications of RDN include reducing the intensity of obstructive sleep apnea (OSA), overcoming insulin resistance, and in chronic kidney disease (CKD) patients. This article aims to provide a comprehensive review of RDN and its uses in cardiology and beyond, along with providing future directions and perspectives.
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