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)
2019年3月26日 更新者:Yonsei University
- (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.
研究概览
研究类型
介入性
注册 (实际的)
16
阶段
- 第四阶段
联系人和位置
本节提供了进行研究的人员的详细联系信息,以及有关进行该研究的地点的信息。
学习地点
-
-
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Seoul、大韩民国、120-752
- Severance Hospital
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-
参与标准
研究人员寻找符合特定描述的人,称为资格标准。这些标准的一些例子是一个人的一般健康状况或先前的治疗。
资格标准
适合学习的年龄
20年 至 85年 (成人、年长者)
接受健康志愿者
不
有资格学习的性别
全部
描述
Inclusion Criteria:
- 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
Exclusion Criteria:
- 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
学习计划
本节提供研究计划的详细信息,包括研究的设计方式和研究的衡量标准。
研究是如何设计的?
设计细节
- 主要用途:治疗
- 分配:随机化
- 介入模型:交叉作业
- 屏蔽:无(打开标签)
武器和干预
参与者组/臂 |
干预/治疗 |
|---|---|
|
有源比较器:控制组
|
Continue hypertensive medication
|
|
实验性的:RD group
Renal denervation group
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Renal denervation will be performed via common femoral artery with standard endovascular technique and simplicity catheter
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Change in coronary atheroma
大体时间:change in coronary atheroma for 24 months after renal denervation
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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
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change in coronary atheroma for 24 months after renal denervation
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Reduction of peak exercise E/E prime
大体时间:Peak exercise E/E prime from 6 and 12 months after renal denervation
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Reduction of peak exercise E/E prime at 6 month follow up for RENEWAL-EXERCISE trial
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Peak exercise E/E prime from 6 and 12 months after renal denervation
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其他结果措施
结果测量 |
措施说明 |
大体时间 |
|---|---|---|
|
Evaluation of the novel methods predicting the successful renal sympathetic denervation after RDN
大体时间:change of blood pressure at 6 and 12 months
|
Evaluation of the novel methods predicting the successful or unsuccessful renal sympathetic denervation after RDN: 1) Effects the change of blood pressure by infusion of intra-renal adenosine at pre- and immediate post-RND on blood pressure at 6 and 12 months; 2) Association of skin sympathetic activity measurement before and immediate post-procedure and blood pressure at 6 and 12 months; RENEWAL-PREDICT trial)
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change of blood pressure at 6 and 12 months
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合作者和调查者
在这里您可以找到参与这项研究的人员和组织。
出版物和有用的链接
负责输入研究信息的人员自愿提供这些出版物。这些可能与研究有关。
研究记录日期
这些日期跟踪向 ClinicalTrials.gov 提交研究记录和摘要结果的进度。研究记录和报告的结果由国家医学图书馆 (NLM) 审查,以确保它们在发布到公共网站之前符合特定的质量控制标准。
研究主要日期
学习开始
2013年8月1日
初级完成 (实际的)
2016年5月27日
研究完成 (实际的)
2016年5月27日
研究注册日期
首次提交
2013年7月9日
首先提交符合 QC 标准的
2013年8月5日
首次发布 (估计)
2013年8月7日
研究记录更新
最后更新发布 (实际的)
2019年3月28日
上次提交的符合 QC 标准的更新
2019年3月26日
最后验证
2016年12月1日
更多信息
此信息直接从 clinicaltrials.gov 网站检索,没有任何更改。如果您有任何更改、删除或更新研究详细信息的请求,请联系 register@clinicaltrials.gov. clinicaltrials.gov 上实施更改,我们的网站上也会自动更新.