NCT01918111终止4 期
Effects of REnal Denervation for Resistant Hypertension on Exercise Diastolic Function and Regression of Atherosclerosis and the Evaluation of NEW Methods Predicting A successfuL Renal Sympathetic Denervation (RENEWAL-EXERCISE, -REGRESS, and -PREDICT Trial From RENEWAL RDN Registry)
适应症
干预措施
相关药物
试验速览
- 阶段
- 4 期
- 状态
- 终止
- 入组人数
- 16
- 试验地点
- 1
- 主要终点
- Change in coronary atheroma
研究概览
简要总结
- (RENEWAL-EXERCISE trial) The investigators hypothesize that the increased sympathetic nervous system activation that is associated with resistant hypertension is a major contributor in the pathogenesis of exercise diastolic dysfunction and that modulation of the sympathetic nervous system activity with radiofrequency ablation of the renal artery sympathetic nerve fibers delivered via a treatment catheter, will have a significant effect on the diastolic function that is beyond BP-lowering effect.
- (RENEWAL-REGRESSION trial) The major cause of mortality and morbidity in hypertension is atherosclerotic cardiovascular disease. the significant decrease in the sympathetic nervous system activation after renal sympathetic denervation will contribute to regression over and beyond it's effect of blood pressure reduction.
- (RENEWAL-PREDICT trial) No data exists regarding the tests or methods predicting the successful renal denervation causing the effective reduction of BP. For these, the investigators sought to perform the new tests such as adenosine infusion test during procedure and skin sympathetic activity measurement before and immediate post-procedure (detailed explanation provided in section of Methods) and then evaluate the association between these tests and reduction of BP following procedures.
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Crossover
- 主要目的
- Treatment
- 盲法
- None
入排标准
- 年龄范围
- 20 Years 至 85 Years（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Patients aged 20-85 years with resistant hypertension defined as systolic BP>140 mmHg (>130 mmHg for diabetes) or diastolic BP>90mmHg (>80 mmHg for diabetes) despite adequate administration of 3 or more different classes of anti-hypertensive medications including diuretics with good adherence and adequate treatment regimen.
- •All agents should be prescribed at optimal dose amounts. BP was based on an average of 3 office BP readings measured according to the general guidelines. Patients are adhering to a stable drug regimen including 3 or more antihypertensive medications (with no changes for a minimum of 2 weeks prior to enrollment).
- •Patients provided with the written, informed consent to participate in this study
排除标准
- •Hemodynamically or anatomically significant renal artery abnormalities, main renal arteries < 4 mm in diameter or < 20 mm in length, or.prior renal artery intervention
- •Estimated glomerular filtration rate (eGFR) of < 30mL/min/1.73m2, using the MDRD calculation
- •Hemodynamically significant valvular heart disease
- •History of congestive heart failure with reduce LV ejection fraction of less than 35%
- •CVA in the prior 3 months
- •ST-segment elevation MI within 48 hours
- •Scheduled or planned surgery or cardiovascular intervention in the next 6 months.
- •Patients with chronic debilitating disease with life expectancy of less than 1 year
- •Patients taking hormone replace treatment and/or oral contraceptives; pregnant, nursing or planning to be pregnant
- •Chronic liver cirrhosis
研究组 & 干预措施
RD group
Experimental
Renal denervation group
干预措施: Renal denervation (Procedure)
Control group
Active Comparator
Control group
干预措施: adenosine infusion treatment (Drug)
结局指标
主要结局
Change in coronary atheroma
时间窗: change in coronary atheroma for 24 months after renal denervation
Evaluation of the change in coronary atheroma (change in percent atheroma volume (PAV) and the change in nominal atheroma volume in the 10-mm subsegment with the greatest disease severity at baseline), analyzed by an IVUS, between baseline and 2-year IVUS in the patients with CAD) for RENEWAL-REGRESS trial
次要结局
- Reduction of peak exercise E/E prime(Peak exercise E/E prime from 6 and 12 months after renal denervation)
研究者
研究点 (1)
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