Effects of baroreflex activation therapy on cardiac function and morphology

Area of Science:

• Cardiology
• Hypertension Research
• Heart Failure Studies

Background:

• Arterial hypertension (aHTN) is a key factor in heart failure with preserved ejection fraction (HFpEF) development and prognosis.
• Therapy-resistant hypertension (trHTN), uncontrolled blood pressure (BP) despite ≥3 medications, significantly increases heart failure risk.
• Baroreflex activation therapy (BAT) is a potential intervention for BP management in challenging hypertensive cases.

Purpose of the Study:

• To evaluate the impact of baroreflex activation therapy (BAT) on cardiac function and morphology.
• To assess BAT's efficacy in patients with therapy-resistant hypertension (trHTN) and heart failure with preserved ejection fraction (HFpEF).
• To compare outcomes in patients with and without HFpEF receiving BAT.

Main Methods:

• Prospective observation of 64 patients with trHTN undergoing BAT implantation (2012-2016).
• Collection of office BP, electrocardiographic, and echocardiographic data pre- and post-BAT implantation.
• Analysis of changes in cardiac structure, function, and medication requirements.

Main Results:

• BAT significantly reduced systolic and diastolic BP in both HFpEF and non-HFpEF groups.
• Patients with HFpEF showed decreased posterior wall diameter and left ventricular mass, with improved e' lateral velocity post-BAT.
• A reduction in heart rate and lengthening of QRS and QTc durations were observed in the overall study population.

Conclusions:

• Baroreflex activation therapy (BAT) effectively lowers BP in patients with trHTN.
• BAT is associated with significant improvements in cardiac morphology and function in patients with HFpEF.
• BAT offers a promising therapeutic option for managing resistant hypertension and its cardiac sequelae.