Baroreflex Activation Therapy in Heart Failure With Reduced Ejection Fraction: Available Data and Future Perspective

被引：11
作者：
Halbach M. [1 ]
Fritz T. [1 ]
Madershahian N. [2 ]
Pfister R. [1 ]
Reuter H. [1 ]
机构：
[1] Department of Internal Medicine III, University of Cologne, Kerpener Str. 62, Cologne
[2] Department of Cardiothoracic Surgery, Heart Center, University of Cologne, Cologne
来源：
Current Heart Failure Reports | 2016年 / 13卷 / 2期
关键词：
Baroreceptors; Baroreflex activation therapy; Carotid sinus stimulation; Heart failure;
D O I：
10.1007/s11897-016-0286-8
中图分类号：
学科分类号：
摘要：
Progression of heart failure with reduced ejection fraction (HFrEF) is promoted by sympathovagal imbalance. Baroreflex activation therapy, i.e., electrical stimulation of baroreceptors at the carotid sinus, can restore sympathovagal balance. Large animal studies of baroreflex activation therapy revealed improvements in cardiac function, susceptibility to ventricular arrhythmias, and a survival benefit as compared to untreated controls. Recently, the first randomized and controlled trial of optimal medical and device therapy alone or plus baroreflex activation therapy in patients suffering from HFrEF was published. It demonstrated a reasonable safety profile in this severely ill patient population. Moreover, the study found significant improvements in New York Heart Association class, quality of life, 6-min walk distance, and NT-proBNP levels. This review provides an overview on baroreflex activation therapy for the treatment of HFrEF—from the concept and preclinical findings to most recent clinical data and upcoming trials. © 2016, Springer Science+Business Media New York.
引用
收藏
页码：71 / 76
页数：5
相关论文
共 20 条
  • [11] Gronda E., Seravalle G., Trevano F.Q., Et al., Long-term chronic baroreflex activation: persistent efficacy in patients with heart failure and reduced ejection fraction, J Hypertens, 33, 8, pp. 1704-1708, (2015)
  • [12] Abraham W.T., Zile M.R., Weaver F.A., Et al., Baroreflex activation therapy for the treatment of heart failure with a reduced ejection fraction, JACC Heart failure, 3, 6, pp. 487-496, (2015)
  • [13] Madershahian N., Scherner M., Muller-Ehmsen J., Et al., Baroreflex activation therapy in patients with pre-existing implantable cardioverter-defibrillator: compatible, complementary therapies, Europace, 16, 6, pp. 861-865, (2014)
  • [14] Cazeau S., Leclercq C., Lavergne T., Et al., Effects of multisite biventricular pacing in patients with heart failure and intraventricular conduction delay, N Engl J Med, 344, 12, pp. 873-880, (2001)
  • [15] Braunwald E., Epstein S.E., Glick G., Et al., Relief of angina pectoris by electrical stimulation of the carotid-sinus nerves, N Engl J Med, 277, 24, pp. 1278-1283, (1967)
  • [16] Burgoyne S., Georgakopoulos D., Belenkie I., Et al., Systemic vascular effects of acute electrical baroreflex stimulation, Am J Physiol Heart Circ Physiol, 307, 2, pp. H236-H241, (2014)
  • [17] Shoukas A.A., Carotid sinus baroreceptor reflex control and epinephrine. Influence on capacitive and resistive properties of the total pulmonary vascular bed of the dog, Circ Res, 51, 1, pp. 95-101, (1982)
  • [18] Shadman R., Poole J.E., Dardas T.F., Et al., A novel method to predict the proportional risk of sudden cardiac death in heart failure: derivation of the Seattle Proportional Risk Model, Heart Rhythm, 12, 10, pp. 2069-2077, (2015)
  • [19] Bisognano J.D., Kaufman C.L., Bach D.S., Et al., Improved cardiac structure and function with chronic treatment using an implantable device in resistant hypertension: results from European and United States trials of the Rheos system, J Am Coll Cardiol, 57, 17, pp. 1787-1788, (2011)
  • [20] Braunwald E., Sobel B.E., Braunwald N.S., Treatment of paroxysmal supraventricular trachycardia by electrical stimulation of the carotid-sinus nerves, N Engl J Med, 281, 16, pp. 885-887, (1969)
12