title: Chronic baroreflex activation: a potential therapeutic approach to heart failure with preserved ejection fraction.
abstract: Heart failure with preserved ejection fraction (HFpEF) is a substantial public health issue, equal in magnitude to heart failure with reduced ejection fraction. Clinical outcomes of HFpEF patients are generally poor, related annual accrual of health care expenses amount to billions of dollars, and no therapy has been shown to be effective in randomized clinical trials. Baroreflex activation therapy (BAT) produced by stimulating the carotid sinuses using an implanted device (Rheos) is being studied for the treatment of hypertension, the primary comorbidity of HFpEF. Other potential benefits include regression of left ventricular hypertrophy, normalization of the sympathovagal balance, inhibition of the renin-angiotensin-aldosterone system, arterio- and venodilation, and preservation of renal function. This paper reviews the evidence suggesting that BAT may be a promising therapy for HFpEF and introduces the HOPE4HF trial (ClinicalTrials.gov Identifier: NCT00957073), a randomized outcomes trial designed to evaluate the clinical safety and efficacy of BAT in the HFpEF population.
authors.affiliation: CVRx Inc., 9201 West Broadway Avenue, Minneapolis, MN 55445, USA. dgeorgakopoulos@cvrx.com
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Georgakopoulos
authors.forename: William C
authors.initials: WC
authors.lastname: Little
authors.forename: William T
authors.initials: WT
authors.lastname: Abraham
authors.forename: Fred A
authors.initials: FA
authors.lastname: Weaver
authors.forename: Michael R
authors.initials: MR
authors.lastname: Zile
mesh_terms: D001341:Autonomic Nervous System; D017704:Baroreflex / Q000502:physiology*; D002304:Cardiac Pacing, Artificial; D002346:Carotid Sinus / Q000294:innervation*; D002908:Chronic Disease; D004558:Electric Stimulation; D006333:Heart Failure / Q000628:therapy*; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000517:prevention & control; D012084:Renin-Angiotensin System; D013318:Stroke Volume; D013997:Time Factors; D016277:Ventricular Function, Left