PMID- 36758670
OWN - NLM
STAT- MEDLINE
DCOM- 20230425
LR  - 20230519
IS  - 1876-4738 (Electronic)
IS  - 0914-5087 (Linking)
VI  - 81
IP  - 6
DP  - 2023 Jun
TI  - Renal denervation in management of heart failure with reduced ejection fraction: 
      A systematic review and meta-analysis.
PG  - 513-521
LID - S0914-5087(23)00021-7 [pii]
LID - 10.1016/j.jjcc.2023.01.010 [doi]
AB  - BACKGROUND: Some, but not all, recent studies have shown that renal denervation 
      (RDN) can improve cardiac function and exercise tolerance in people who have 
      heart failure with reduced ejection fraction (HFrEF). This study assessed the 
      efficacy and safety of RDN as a treatment for HFrEF. METHODS: The Medline, 
      Cochrane Library, Embase, and PubMed databases were searched through to September 
      28, 2022 for clinical studies that evaluated the effect of RDN on HFrEF. The 
      primary endpoints were changes in left ventricular ejection fraction (LVEF) and 
      6-min walk distance (6MWD). Secondary endpoints were changes in echocardiographic 
      parameters, including left ventricular end-diastolic and end-systolic diameters, 
      left atrial diameter, and interventricular septal thickness. N-terminal 
      pro-B-type natriuretic peptide (NT-proBNP) levels, New York Heart Association 
      (NYHA) class, heart rate, and systolic and diastolic blood pressure were also 
      evaluated. Major adverse events were defined as death and rehospitalization for 
      heart failure during follow-up. The estimated glomerular filtration rate (eGFR) 
      and serum creatinine level were extracted as measures of renal function. RESULTS: 
      Eleven trials comprising 313 patients were eligible for quantitative analysis. 
      Pooled analyses showed a mean increase in LVEF of 4.25 % (95 % CI 1.77-6.72; 
      p < 0.001, I(2) = 69 %) and an increase in 6MWD (mean difference 50.28 m, 95 % CI 
      8.78-91.78; p = 0.02; I(2) = 81 %) after RDN. Left ventricular end-diastolic and 
      end-systolic diameters, left atrial diameter, and interventricular septal 
      thickness also improved after RDN. NT-proBNP, NYHA class, and heart rate were 
      significantly decreased after RDN. There were no significant changes in blood 
      pressure after RDN. Mortality and HF-related hospitalization rates were 
      relatively low. There was no significant change in eGFR or creatinine after RDN. 
      CONCLUSIONS: Our findings suggest that RDN can effectively increase LVEF and 6MWD 
      in patients with HFrEF but require confirmation in studies with larger sample 
      sizes and longer follow-up durations.
CI  - Copyright (c) 2023 Elsevier Ltd. All rights reserved.
FAU - Li, Min
AU  - Li M
AD  - Department of Cardiovascular Disease, Peking University First Hospital, Beijing, 
      China.
FAU - Ma, Wei
AU  - Ma W
AD  - Department of Cardiovascular Disease, Peking University First Hospital, Beijing, 
      China; Echocardiography Core Lab, Institute of Cardiovascular Disease at Peking 
      University First Hospital, Beijing, China; Hypertension Precision Diagnosis and 
      Treatment Research Center, Peking University First Hospital, Beijing, China. 
      Electronic address: km_mawei@bjmu.edu.cn.
FAU - Fan, Fangfang
AU  - Fan F
AD  - Department of Cardiovascular Disease, Peking University First Hospital, Beijing, 
      China.
FAU - Yi, Tieci
AU  - Yi T
AD  - Department of Cardiovascular Disease, Peking University First Hospital, Beijing, 
      China.
FAU - Qiu, Lin
AU  - Qiu L
AD  - Department of Cardiovascular Disease, Peking University First Hospital, Beijing, 
      China.
FAU - Wang, Zhi
AU  - Wang Z
AD  - Department of Cardiovascular Disease, Peking University First Hospital, Beijing, 
      China.
FAU - Weng, Haoyu
AU  - Weng H
AD  - Department of Cardiovascular Disease, Peking University First Hospital, Beijing, 
      China.
FAU - Zhang, Yan
AU  - Zhang Y
AD  - Department of Cardiovascular Disease, Peking University First Hospital, Beijing, 
      China; Key Laboratory of Molecular Cardiovascular Sciences (Peking University), 
      Ministry of Education, Beijing, China.
FAU - Li, JianPing
AU  - Li J
AD  - Department of Cardiovascular Disease, Peking University First Hospital, Beijing, 
      China; Key Laboratory of Molecular Cardiovascular Sciences (Peking University), 
      Ministry of Education, Beijing, China.
FAU - Huo, Yong
AU  - Huo Y
AD  - Department of Cardiovascular Disease, Peking University First Hospital, Beijing, 
      China; Key Laboratory of Molecular Cardiovascular Sciences (Peking University), 
      Ministry of Education, Beijing, China.
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Research Support, Non-U.S. Gov't
PT  - Systematic Review
DEP - 20230208
PL  - Netherlands
TA  - J Cardiol
JT  - Journal of cardiology
JID - 8804703
SB  - IM
MH  - Humans
MH  - *Heart Failure/surgery
MH  - Stroke Volume
MH  - Ventricular Function, Left/physiology
MH  - *Atrial Fibrillation
MH  - Kidney/physiology
MH  - Denervation
OTO - NOTNLM
OT  - 6-min walk distance
OT  - Heart failure
OT  - Left ventricular ejection fraction
OT  - Renal denervation
COIS- Declaration of competing interest The authors declare that there is no conflict 
      of interest.
EDAT- 2023/02/10 06:00
MHDA- 2023/04/25 06:42
CRDT- 2023/02/09 19:23
PHST- 2022/11/01 00:00 [received]
PHST- 2022/12/13 00:00 [revised]
PHST- 2023/01/02 00:00 [accepted]
PHST- 2023/04/25 06:42 [medline]
PHST- 2023/02/10 06:00 [pubmed]
PHST- 2023/02/09 19:23 [entrez]
AID - S0914-5087(23)00021-7 [pii]
AID - 10.1016/j.jjcc.2023.01.010 [doi]
PST - ppublish
SO  - J Cardiol. 2023 Jun;81(6):513-521. doi: 10.1016/j.jjcc.2023.01.010. Epub 2023 Feb 
      8.