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Renal denervation in heart failure with preserved ejection fraction (RDT-PEF): a randomized controlled trial.

Abstract：

AIM:Heart failure with preserved ejection fraction (HFpEF) is associated with increased sympathetic nervous system (SNS) tone. Attenuating the SNS with renal denervation (RDT) might be helpful and there are no data currently in humans with HFpEF. METHODS AND RESULTS:In this single-centre, randomized, open-controlled study we included 25 patients with HFpEF [preserved left ventricular (LV) ejection fraction, left atrial (LA) dilatation or LV hypertrophy and raised B-type natriuretic peptide (BNP) or echocardiographic assessment of filling pressures]. Patients were randomized (2:1) to RDT with the Symplicity™ catheter or continuing medical therapy. The primary success criterion was not met in that there were no differences between groups at 12 months for Minnesota Living with Heart Failure Questionnaire score, peak oxygen uptake (VO2 ) on exercise, BNP, E/e', LA volume index or LV mass index. A greater proportion of patients improved at 3 months in the RDT group with respect to VO2 peak (56% vs. 13%, P = 0.025) and E/e' (31% vs. 13%, P = 0.04). Change in estimated glomerular filtration rate was comparable between groups. Two patients required plain balloon angioplasty during the RDT procedure to treat renal artery wall oedema. CONCLUSION:This study was terminated early because of difficulties in recruitment and was underpowered to detect whether RD improved the endpoints of quality of life, exercise function, biomarkers, and left heart remodelling. The procedure was safe in patients with HFpEF, although two patients did require intraprocedure renal artery dilatation.

journal_name

Eur J Heart Fail

journal_title

European journal of heart failure

authors

Patel HC,Rosen SD,Hayward C,Vassiliou V,Smith GC,Wage RR,Bailey J,Rajani R,Lindsay AC,Pennell DJ,Underwood SR,Prasad SK,Mohiaddin R,Gibbs JS,Lyon AR,Di Mario C

doi

10.1002/ejhf.502

subject

Has Abstract

pub_date

2016-06-01 00:00:00

pages

703-12

issue

6

eissn

1388-9842

issn

1879-0844

journal_volume

18

pub_type

杂志文章,随机对照试验

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