title: Effects of percutaneous renal sympathetic denervation on cardiac function and exercise tolerance in patients with chronic heart failure.
abstract: BACKGROUND
  Sympathetic hyperactivity, a vital factor in the genesis and development of heart failure (HF), has been reported to be effectively reduced by percutaneous renal denervation (RDN), which may play an important role in HF treatment.
  
  
  OBJECTIVE
  To determine the effects of percutaneous RDN on cardiac function in patients with chronic HF (CHF).
  
  
  METHODS
  Fourteen patients (mean age 69.6 years; ejection fraction [EF] <45%) with CHF received bilateral RDN. Adverse cardiac events, blood pressure (BP), and biochemical parameters were assessed before and six months after percutaneous operation. Patients also underwent echocardiographic assessment of cardiac function and 6-min walk test before and at six months after percutaneous operation.
  
  
  RESULTS
  The distance achieved by the 14 patients in the 6-min walk test increased significantly from 152.9±38.0 m before RDN to 334.3±94.4 m at six months after RDN (p<0.001), while EF increased from 36.0±4.1% to 43.8±7.9% (p=0.003) on echocardiography. No RDN-related complications were observed during the follow-up period. In 6-month follow-up, systolic BP decreased from 138.6±22.1 mmHg to 123.2±10.5 mmHg (p=0.026) and diastolic BP from 81.1±11.3 mmHg to 72.9±7.5 mmHg (p=0.032). Creatinine levels did not change significantly (1.3±0.65 mg/dl to 1.2±0.5 mg/dl, p=0.8856).
  
  
  CONCLUSIONS
  RDN is potentially an effective technique for the treatment of severe HF that can significantly increase EF and improve exercise tolerance.
authors.affiliation: Department of Cardiology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, People's Republic of China.
authors.forename: Jun-Qing
authors.initials: JQ
authors.lastname: Gao
authors.affiliation: Department of Cardiology, People's Hospital of Shanghai Putuo District, Shanghai 200060, People's Republic of China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Xie
authors.affiliation: Department of Cardiology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, People's Republic of China.
authors.forename: Wei
authors.initials: W
authors.lastname: Yang
authors.affiliation: Department of Cardiology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, People's Republic of China.
authors.forename: Jian-Pu
authors.initials: JP
authors.lastname: Zheng
authors.affiliation: Department of Cardiology, Putuo Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200062, People's Republic of China. Electronic address: 95885209@qq.com.
authors.forename: Zong-Jun
authors.initials: ZJ
authors.lastname: Liu
mesh_terms: D000368:Aged; D002908:Chronic Disease; D017079:Exercise Tolerance; D005260:Female; D006321:Heart / Q000503:physiopathology*; D006333:Heart Failure / Q000503:physiopathology* / Q000601:surgery*; D006801:Humans; D007668:Kidney / Q000294:innervation* / Q000601:surgery*; D008297:Male; D011446:Prospective Studies; D013562:Sympathectomy / Q000379:methods; D013997:Time Factors; D016896:Treatment Outcome
keywords: Blood pressure; Desnervação renal; Heart failure; Insuficiência cardíaca; Pressão arterial; Renal denervation; Sistema nervoso simpático; Sympathetic nervous system