Device-Based Sympathetic Nerve Regulation for Cardiovascular Diseases

Area of Science:

• Cardiology
• Medical Devices
• Neurology

Background:

• Sympathetic overactivation exacerbates cardiovascular diseases (CVDs) by promoting ventricular remodeling, endothelial injury, and plaque progression.
• Device-based sympathetic nerve (SN) regulation presents a novel therapeutic avenue for managing CVDs.

Purpose of the Study:

• To review the pathophysiological basis and current clinical evidence for device-based therapies targeting sympathetic overactivation in CVDs.
• To highlight emerging device-based SN regulation strategies beyond renal denervation.

Main Methods:

• Review of existing literature on device-based sympathetic nerve modulation for cardiovascular conditions.
• Analysis of clinical trial data for therapies such as renal denervation (RDN), pulmonary artery denervation (PADN), hepatic artery denervation (HADN), and splenic artery denervation (SADN).

Main Results:

• Renal denervation (RDN) is validated in resistant hypertension and shows promise in heart failure and arrhythmias.
• Pulmonary artery denervation (PADN) effectively manages pulmonary hypertension.
• Emerging techniques like HADN and SADN are under investigation for metabolic and inflammatory-immune CVDs, with ongoing first-in-man studies.

Conclusions:

• Device-based SN regulation offers a viable therapeutic strategy for various CVDs.
• Continued research into novel denervation techniques and other device-based therapies is crucial for advancing cardiovascular care.