International Circulation: I would first like to ask how we can predict response to renal denervation， especially when determining responders and non-responders?
Professor Michael Bohm: We have determined clinical predictors of response in about 450 patients. The best and only predictor of response is the height of the blood pressure at base line: the higher the blood pressure， the greater the response. There is no interaction with age， renal function， obesity， and diabetes， which we had initially thought. It came out that these are no the true predictors. Another point is heart rate. Patients with a higher heart rate have a better response beyond blood pressure. They respond according to blood pressure and heart rate.
《国际循环》：我们应该如何预测患者对肾脏去神经术的反应，尤其是识别有反应者和无反应者？
Bohm教授：我们在450例患者中确定了对RND有反应的临床预测因子。最佳也是唯一的预测因子是基线时血压水平。血压越高，反应越强。年龄、肾功能、肥胖、糖尿病与之均无交互作用，这与我们原来的设想不同，这些都不是真正的预测因子。心率是另一个因素，心率快的患者在血压之外有更好的应答。患者根据血压和心率水平对RND应答。
International Circulation: Can denervation be used for other syndromes? Some research has suggested it may help EGFR and therefore might help improve outcomes for CDK.
Prof. Bohm: There are some ongoing pilot studies. We have already tried denervation therapy in patients with renal impairment， with a GFR between 10 and 40. They have the same response concerning their blood pressure reduction. They have no increased or marked worsening of renal function， so it appears to be safe in this population. Furthermore， there are ongoing pilot studies on heart failure. There will be a big heart failure trail looking at clinical endpoints. At the end of the day， it will be necessary to have endpoint trials here as well.
《国际循环》：RND可以用于其他疾病吗？一些研究提示它可能改善EGFR，因此可能改善慢性肾病的转归？
Bohm教授：有一些预试验正在进行之中。我们已经在肾功能不全，GFR 10～40的患者中使用RND。就血压降低程度而言，与其他患者一致。他们的肾功能没有改善，也没有恶化，因此RND在这个人群中看上去是安全的。心力衰竭的预试验也正在进行中。有一项大型心力衰竭试验观察临床终点。最终，我们需要临床硬终点试验。
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