title: Autonomic Modulation With Baroreflex Activation Therapy in Heart Failure.
abstract: Baroreflex activation therapy (BAT) produces a central inhibition of cardiac sympathetic outflow and, concomitantly, an increased cardiac vagal activity via a physiological reflex pathway. In a pilot study in 11 patients with NYHA class III heart failure (HF), BAT produced a persistent significant reduction of muscle sympathetic nerve activity over a 21-month follow-up and a dramatic decrease in the number and length of hospitalizations. In a multinational, prospective, randomized, parallel-controlled, clinical trial in 146 NYHA functional class III HF, BAT produced a significant N-terminal pro-brain natriuretic peptide reduction (p = 0.02). This was associated with a trend toward few in hospital days for HF. BAT might become a powerful tool to manipulate autonomic alterations of HF at their origin and thus profoundly affect advanced HF patient prognosis.
authors.affiliation: Cardiovascular Department, IRCCS MultiMedica, Via Milanese 300, Sesto San Giovanni, 20141, Milan, Italy. edoardo.gronda@multimedica.it.
authors.forename: Edoardo
authors.initials: E
authors.lastname: Gronda
authors.affiliation: Cardiovascular Department, IRCCS MultiMedica, Via Milanese 300, Sesto San Giovanni, 20141, Milan, Italy.|Department of Molecular Medicine, University of Pavia, Pavia, Italy.
authors.forename: Emilio
authors.initials: E
authors.lastname: Vanoli
mesh_terms: D001341:Autonomic Nervous System / Q000502:physiology; D017704:Baroreflex / Q000502:physiology*; D006333:Heart Failure / Q000628:therapy*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood; D010865:Pilot Projects; D011446:Prospective Studies; D016032:Randomized Controlled Trials as Topic; D013564:Sympathetic Nervous System
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Autonomic nervous system; Baroreflex activation; Heart failure; Non-pharmacologic therapy