Effects of percutaneous renal sympathetic denervation on cardiac function and exercise tolerance in patients with chronic heart failure

Introduction: Sympathetic hyperactivity, a vital factor in the genesis and development of heart failure (HF), has been reported to be effectively reduced by percutaneous renal denervation (RDN), which may play an important role in HF treatment. Objective: To determine the effects of percutaneous RDN on cardiac function in patients with chronic HF (CHF). Methods: Fourteen patients (mean age 69.6 years; ejection fraction [EF] <45%) with CHF received bilateral RDN. Adverse cardiac events, blood pressure (BP), and biochemical parameters were assessed before and six months after percutaneous operation. Patients also underwent echocardiographic assessment of cardiac function and 6-min walk test before and at six months after percutaneous operation. Results: The distance achieved by the 14 patients in the 6-min walk test increased significantly from 152.9 +/- 38.0 m before RDN to 334.3 +/- 94.4 m at six months after RDN (p<0.001), while EF increased from 36.0 +/- 4.1% to 43.8 +/- 7.9% (p=0.003) on echocardiography. No RDN-related complications were observed during the follow-up period. In 6-month follow-up, systolic BP decreased from 138.6 +/- 22.1 mmHg to 123.2 +/- 10.5 mmHg (p=0.026) and diastolic BP from 81.1 +/- 11.3 mmHg to 72.9 +/- 7.5 mmHg (p=0.032). Creatinine levels did not change significantly (1.3 +/- 0.65 mg/dl to 1.2 +/- 0.5 mg/dl, p=0.8856). Conclusion: RDN is potentially an effective technique for the treatment of severe HF that can significantly increase EF and improve exercise tolerance. (C) 2016 Sociedade Portuguesa de Cardiologia. Published by Elsevier Espana, S.L.U. All rights reserved.