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Splanchnic Nerve Modulation Effects on Surrogate Measures of Venous Capacitance
Veraprapas Kittipibul1, Arun Ganesh2, Aubrie Coburn1
1Division of Cardiology, Department of Medicine Duke University Durham NC.
Journal of the American Heart Association
|July 14, 2023
Summary
Splanchnic nerve modulation (SNM) increases venous capacitance, reducing cardiac preload in heart failure patients. This procedure also decreased bendopnea, a symptom of fluid overload.
Area of Science:
- Cardiology
- Nephrology
- Vascular Medicine
Background:
- Splanchnic nerve modulation (SNM) is an emerging treatment for heart failure.
- Its mechanism for reducing cardiac filling pressures is thought to involve increased venous capacitance, but evidence is limited.
Purpose of the Study:
- To investigate changes in venous capacitance surrogates before and after SNM in heart failure patients.
- To assess the impact of SNM on cardiac preload and related symptoms.
Main Methods:
- A prospective, open-label, single-arm study involving 15 chronic heart failure patients.
- Hemodynamic assessments, including Valsalva maneuver and inferior vena cava (IVC) measurements, were performed pre- and post-SNM.
- Bendopnea and exercise-induced hemoconcentration were also evaluated.
Main Results:
- SNM increased systolic blood pressure response during the Valsalva maneuver (P=0.025).
- IVC diameter decreased (P=0.034) with increased collapsibility (P=0.014), indicating enhanced venous capacitance.
- Bendopnea prevalence decreased significantly (P=0.025).
Conclusions:
- SNM effectively increases venous capacitance, leading to decreased cardiac preload and reduced bendopnea in heart failure.
- Minimally invasive venous capacitance measures may indicate successful SNM.
- Further research is needed on the long-term effects of SNM for heart failure management.
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