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Baroreflex activation therapy for the treatment of heart failure with reduced ejection fraction in patients with and without coronary artery disease.

Abstract：

BACKGROUND:In a randomized trial, baroreflex activation therapy (BAT) improved exercise capacity, quality of life and NT-proBNP in patients with heart failure with reduced ejection fraction (HFrEF). In view of different mechanisms underlying HFrEF, we performed a post-hoc subgroup analysis of efficacy and safety of BAT in patients with and without coronary artery disease (CAD). METHODS AND RESULTS:Patients with left ventricular ejection fraction <35% and NYHA Class III were randomized 1:1 to guideline-directed medical and device therapy alone or plus BAT. Patients with a history of CAD, prior myocardial infarction or coronary artery bypass graft were assigned to the CAD group with all others assigned to the no-CAD group. Of 71 BAT treated patients, 52 had CAD and 19 had no CAD. In the control group, 49 of 69 patients had CAD and 20 had no CAD. The system- or procedure-related major adverse neurological or cardiovascular event rate was 3.8% in the CAD group vs. 0% in the no-CAD group (p = 1.0). In the whole cohort, NYHA Class, Minnesota Living with Heart Failure score, 6-minute hall walk distance and NTproBNP were improved in BAT treated patients compared with controls. Statistical analyses revealed no interaction between the presence of CAD and effect of BAT (all p > 0.05). CONCLUSION:No major differences were found in BAT efficacy or safety between patients with and without CAD, indicating that BAT improves exercise capacity, quality of life and NTproBNP in patients with ischemic and non-ischemic cardiomyopathy. CLINICALTRIALS. GOV IDENTIFIER:NCT01471860 and NCT01720160.

journal_name

Int J Cardiol

journal_title

International journal of cardiology

authors

Halbach M,Abraham WT,Butter C,Ducharme A,Klug D,Little WC,Reuter H,Schafer JE,Senni M,Swarup V,Wachter R,Weaver FA,Wilks SJ,Zile MR,Müller-Ehmsen J

doi

10.1016/j.ijcard.2018.04.075

subject

Has Abstract

pub_date

2018-09-01 00:00:00

pages

187-192

eissn

0167-5273

issn

1874-1754

pii

S0167-5273(18)31351-2

journal_volume

266

pub_type

杂志文章,随机对照试验

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