Long-term chronic baroreflex activation: Persistent efficacy in patients with heart failure and reduced ejection fraction

Edoardo Gronda, Gino Seravalle, Fosca Quarti Trevano, Giuseppe Costantino, Andrea Casini, Ali Alsheraei, Eric G. Lovett, Emilio Vanoli, Giuseppe Mancia, Guido Grassi

Research output: Contribution to journalArticlepeer-review

Abstract

Aims: Baroreflex activation therapy (BAT) has recently been shown to reduce muscle sympathetic nerve activity and hospitalization rate while improving clinical variables through 6 months of therapy in patients with heart failure and reduced ejection fraction (HFrEF). The objective of the present study is to extend the information on this patient cohort over a long-term follow-up. Methods and results: Eleven patients were enrolled in the study and presented with optimized, stable medical therapy, New York Heart Association Class III HFrEF with left ventricular ejection fraction 40% or less, impaired functional capacity and no active cardiac resynchronization therapy. For the present report, muscle sympathetic nerve activity, baroreflex sensitivity data and hospitalization rate together with standard clinical data were collected at 12 and 21.5±4.2 months following BAT activation. Two patients died during long-term follow-up. The remaining nine patients maintained the improvements observed at 6 months, including reduced sympathetic activity and rates of hospitalization. Conclusion: BAT provides long-term chronic reductions in sympathetic activity and utilization of hospital resources in patients with HFrEF. General clinical presentation, quality of life and functional capacity are likewise improved and maintained. The temporal association of BAT with sympathetic drive diminution and improvement in objective clinical measures suggests a cause-and-effect relationship that will be verified in future randomized controlled trials of outcome.

Original languageEnglish
Pages (from-to)1704-1708
Number of pages5
JournalJournal of Hypertension
Volume33
Issue number8
DOIs
Publication statusPublished - Aug 11 2015

Keywords

  • autonomic nervous system
  • baroreflex
  • heart failure

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

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