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Effects of chronic carotid baroreceptor activation on arterial stiffness in severe heart failure

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Abstract

Background

Heart failure with reduced ejection fraction (HFrEF) is characterized by activation of the sympathetic nervous system and increased arterial stiffness, leading to an impaired ventricular-vascular coupling. Baroreflex activation therapy (BAT) has been shown to reduce muscle sympathetic nerve activity (MSNA) and improve clinical status of patients with HFrEF. The purpose of this investigation was to determine the effects of BAT on arterial stiffness in HFrEF.

Methods and results

MSNA, clinical variables, and parameters of central blood pressure (BP) and arterial stiffness were collected in 18 NYHA Class III HFrEF patients, nine receiving BAT and nine continuing with optimal medical management alone. Patients were followed for 3 months, with measurements at that time compared to baseline evaluation. Baseline characteristics of the groups were well matched. At 3 months, BAT did not improve central BP and arterial stiffness despite a significant amelioration of MSNA, NYHA class, Minnesota living with heart failure questionnaire score, number of heart failure medications and six-minute walking distance. The control group exhibited no significant changes in all the measured variables.

Conclusions

Despite significant reductions in MSNA and clinical improvement, BAT does not appear to chronically modify arterial stiffness within this HFrEF cohort. Additional study is required to determine if this result applies to the HFrEF population as a whole.

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Authors and Affiliations

  1. Cardiovascular Department, IRCCS Multimedica, Sesto San Giovanni, Milan, Italy

    Edoardo Gronda, Giuseppe Costantino, Emilio Vanoli & Guido Grassi

  2. Clinica Medica, University of Milano-Bicocca, Via Pergolesi 33, 20090, Monza, Italy

    GianMaria Brambilla, Alessandro Maloberti, Matteo Cairo & Guido Grassi

  3. Istituto Auxologico, Milan, Italy

    Gino Seravalle & Giuseppe Mancia

  4. CVRx Inc., Minneapolis, MN, USA

    Eric Lovett

Authors
  1. Edoardo Gronda
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  2. GianMaria Brambilla
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  3. Gino Seravalle
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  5. Matteo Cairo
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  6. Giuseppe Costantino
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  7. Eric Lovett
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  8. Emilio Vanoli
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  9. Giuseppe Mancia
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  10. Guido Grassi
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Corresponding author

Correspondence to Guido Grassi.

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None declared.

Funding

The study reported herein was sponsored by CVRx Inc.

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Gronda, E., Brambilla, G., Seravalle, G. et al. Effects of chronic carotid baroreceptor activation on arterial stiffness in severe heart failure. Clin Res Cardiol 105, 838–846 (2016). https://doi.org/10.1007/s00392-016-0992-y

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  • DOI: https://doi.org/10.1007/s00392-016-0992-y

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