肾动脉消融改善心脏再同步化治疗无效的扩张型心肌病患者慢性心力衰竭的临床研究

目的：前瞻性研究肾动脉交感神经消融术对心脏再同步化治疗（CRT）无效的扩张型心肌病患者慢性心力衰竭的疗效及安全性。方法共入选6例扩张型心肌病患者，均为对CRT无反应者，予以双侧肾动脉交感神经消融术。随访半年，观察术后患者血液理化指标及心功能的变化。结果术后患者血压未见明显变化；肾功能未见明显变化；心率明显减慢；左心室舒张收缩末期内径、左心房前后径明显变小，左心室射血分数改善，6min步行距离明显增加；同时患者血脑利钠肽前体（Pro- BNP）、肾素、醛固酮、高敏C反应蛋白（hs- CRP）等指标均有所改善。结论肾动脉交感神经消融术能改善CRT无效的扩张型心肌病患者的慢性心力衰竭症状。

Renal sympathetic nerve ablation in treatment of chronic heart failure for patients with dilated cardiomyopathy non-responding to car-diac resynchronization therapy

Objective To evaluate the efficacy and safety of renal sympathetic nerve ablation in treatment of chronic heart failure for patients with dilated cardiomyopathy non- responding to cardiac resynchronization therapy. Methods Six patients with dilated cardiomyopathy who did not respond to cardiac resynchronization therapy were included in the study. Al patients had bilat-eral renal artery sympathetic nerve radiofrequency ablation. Patients were followed up for 6 months, and the changes of cardiac function and blood biochemical parameters were observed. Results The heart rates in all patients were decreased without any changes in blood pressure and in renal function after treatment. The left ventricular diastolic systolic diameters, left atrial diameter were significantly reduced;left ventricular ejection fraction and 6- min walking distance were significantly improved;and serum BNP, renin, aldosterone and CRP levels were decreased significantly after the treatment. Conclusion Renal denervation can improve symptoms of chronic heart failure in patients with dilated cardiomyopathy non- responding to cardiac resynchronization therapy.