Baroreflex Activation Therapy in Heart Failure With Reduced Ejection Fraction: Available Data and Future Perspective
Marcel Halbach1, Thorsten Fritz2, Navid Madershahian3
1Department of Internal Medicine III, University of Cologne, Kerpener Str. 62, 50937, Cologne, Germany. marcel.halbach@uk-koeln.de.
Current Heart Failure Reports
|February 17, 2016
Summary
Baroreflex activation therapy can improve heart failure with reduced ejection fraction (HFrEF) by restoring sympathovagal balance. Clinical trials show it is safe and enhances patient outcomes, including functional capacity and quality of life.
Area of Science:
- Cardiology
- Neuroscience
- Biomedical Engineering
Background:
- Sympathovagal imbalance accelerates heart failure with reduced ejection fraction (HFrEF) progression.
- Baroreflex activation therapy (BAT) aims to restore sympathovagal balance through carotid sinus nerve stimulation.
- Preclinical studies in large animals demonstrated BAT's efficacy in improving cardiac function and survival.
Purpose of the Study:
- To review the concept, preclinical evidence, and clinical data of baroreflex activation therapy for HFrEF.
- To summarize recent clinical trial findings on BAT in HFrEF patients.
- To discuss future directions and upcoming trials for BAT in HFrEF treatment.
Main Methods:
- Review of preclinical large animal studies on BAT in heart failure models.
- Analysis of the first randomized controlled trial comparing optimal medical/device therapy with or without BAT in HFrEF patients.
- Synthesis of safety and efficacy data from recent clinical investigations.
Main Results:
- BAT demonstrated a favorable safety profile in a severely ill HFrEF population.
- Significant improvements were observed in New York Heart Association class, quality of life, 6-minute walk distance, and NT-proBNP levels.
- Preclinical data indicated enhanced cardiac function, reduced arrhythmia susceptibility, and improved survival.
Conclusions:
- Baroreflex activation therapy is a promising treatment modality for heart failure with reduced ejection fraction.
- Clinical evidence supports BAT's safety and efficacy in improving functional status and biomarkers in HFrEF.
- Further clinical trials are warranted to establish BAT's role in HFrEF management.
More Related Videos
09:56Implantation of Combined Telemetric ECG and Blood Pressure Transmitters to Determine Spontaneous Baroreflex Sensitivity in Conscious Mice
Published on: February 14, 2021
6.1K
10:39Rat Model of Right-Sided Cardiac Remodeling and Arrhythmia Using Pulmonary Artery Banding
Published on: August 30, 2024
1.5K
Related Concept Videos
01:26Heart Failure Drugs: Inhibitors of Renin-Angiotensin System
1.4K
The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
1.4K
01:30Heart Failure V: Medical Management
512
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
512
01:22Heart Failure VI: Adjunct Therapies
537
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
537
01:22Heart Failure Drugs: β-Blockers
1.1K
β-adrenergic antagonists, commonly known as β-blockers, block the effects of sympathetic neurotransmitters such as noradrenaline (NA) and adrenaline (ADR). They have several beneficial effects in heart failure treatment. They reduce heart rate, the force of contraction, and cardiac muscle relaxation. They also slow the atrial-ventricular conduction rate and raise the threshold for arrhythmias. The concentration of β-blockers determines their effects on bronchodilation,...
1.1K
01:29Heart Failure II: Pathophysiology
1.3K
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
1.3K
01:25Aortic Regurgitation III: Medical Management
547
Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
547