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Copeptin Levels in Patients With Treatment-Resistant Hypertension Before and 6 Months After Renal Denervation.

治疗抵抗性高血压患者去肾神经支配前和 6 个月后的和肽素水平。

  • 影响因子:2.49
  • DOI:10.1093/ajh/hpz155
  • 作者列表:"Bosch A","Schmid A","Ott C","Kannenkeril D","Karg MV","Ditting T","Veelken R","Uder M","Schmieder RE
  • 发表时间:2020-02-22
Abstract

BACKGROUND:Copeptin, the C-terminal peptide of provasopressin, is released from the neurohypophysis and reflects the activity of the hormone arginine vasopressin in patients with hypertension. Elevated copeptin levels are associated with increased cardiovascular and all-cause mortality. The aim of this study is to compare copeptin levels in patients with treatment-resistant hypertension (TRH) before and 6 months after renal denervation (RDN). METHODS:Copeptin was measured in 34 patients with TRH and 30 patients with primary hypertension stage 1 or 2 (HT). In addition, copeptin levels were measured in patients with TRH at 6-month follow-up visit after RDN. RDN was performed by an experienced interventionalist applying at least 4 ablations longitudinally and rotationally within the lengths of each renal artery to cover a full 4-quadrant ablation. RESULTS:In patients with TRH 24-hour ambulatory blood pressure (BP) decreased from 154 ± 15/87 ± 12 mm Hg to 146 ± 13/83 ± 7.9 mm Hg after RDN (systolic: P = 0.001, diastolic: P = 0.034). There was no significant change in copeptin levels in these 34 patients with TRH before vs. 6 months after RDN (median 8.4 [interquartile range 3.6-14] vs. 8.5 [4.5-13] pmol/l, P = 0.334). Patients with TRH had higher copeptin levels (P = 0.024) than patients with HT (24-hour ambulatory BP: 142 ± 11/91 ± 8.3 mm Hg, copeptin: 4.2 [2.8-6.3] pmol/l). CONCLUSION:Patients with TRH showed 2-fold higher copeptin levels than patients with HT. RDN did not lead to any change of copeptin levels in patients with TRH 6 months after procedure despite significant fall in BP. CLINICAL TRIAL REGISTRATION:NCT01318395, NCT01687725.

摘要

背景: 和肽素 (Copeptin) 是普罗帕素的 C 端肽,由神经垂体释放,反映了高血压患者激素精氨酸加压素的活性。和肽素水平升高与心血管和全因死亡率增加有关。本研究的目的是比较治疗抵抗性高血压 (TRH) 患者去肾神经支配 (RDN) 前和 6 个月后的和肽素水平。 方法: 测定 34 例 TRH 患者和 30 例原发性高血压 1 、 2 期 (HT) 患者的和肽素。此外,在 RDN 后 6 个月随访时测定 TRH 患者的 copeptin 水平。RDN 由经验丰富的介入医师进行,在每条肾动脉长度内纵向旋转至少 4 次消融,以覆盖完整的 4 象限消融。 结果: TRH 患者 RDN 后 24 小时动态血压 (BP) 从 154 ± 15/87 ± 12毫米 Hg 降至 146 ± 13/83 ± 7.9毫米 Hg (收缩压: P = 0.001, 舒张期: P = 0.034)。这 34 例 TRH 患者 RDN 前与 RDN 后 6 个月的 copeptin 水平无显著变化 (中位数 8.4 [四分位距 3.6-14] vs。 8.5 [4.5-13] pmol/l,P = 0.334)。TRH 患者的 copeptin 水平 (P = 0.024) 高于 HT 患者 (24 小时动态血压: 142 ± 11/91 ± 8.3毫米 Hg,copeptin: 4.2 [2.8-6.3] pmol/l)。 结论: TRH 患者的 copeptin 水平是 HT 患者的 2 倍。RDN 未导致 TRH 患者术后 6 个月 copeptin 水平的任何变化,尽管 BP 显著下降。 临床试验注册: NCT01318395,nct01687725。

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