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Baroreflex Activation Therapy in Congestive Heart Failure: Novel Findings and Future Insights

  • Secondary Hypertension: Nervous System Mechanisms (M Wyss, Section Editor)
  • Published:
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Abstract

Congestive heart failure is characterized by hemodynamic and non-hemodynamic abnormalities, the latter including an activation of the sympathetic influences to the heart and peripheral circulation coupled with an impairment of baroreceptor control of autonomic function. Evidence has been provided that both these alterations are hallmark features of the disease with a specific relevance for the disease progression as well as for the development of life-threatening cardiac arrhythmias. In addition, a number of studies have documented in heart failure the adverse prognostic role of the sympathetic and baroreflex alterations, which both are regarded as major independent determinants of cardiovascular morbidity and mortality. This represents the pathophysiological and clinical background for the use of carotid baroreceptor activation therapy in the treatment of congestive heart failure. Promising data collected in experimental animal models of heart failure have supported the recent performance of pilot small-scale clinical studies, aimed at providing initial information in this area. The results of these studies demonstrated the clinical safety and efficacy of the intervention which has been tested in large-scale clinical studies. The present paper will critically review the background and main results of the published studies designed at defining the clinical impact of baroreflex activation therapy in congestive heart failure patients. Emphasis will be given to the strengths and limitations of such studies, which represent the background for the ongoing clinical trials testing the long-term effects of the device in heart failure patients.

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Authors and Affiliations

  1. Clinica Medica, University of Milan - Bicocca, Via Pergolesi 33, 20090, Monza, Italy

    Guido Grassi & Daniela Prata Pizzalla

  2. IRCCS Multimedica, Sesto San Giovanni, Milan, Italy

    Guido Grassi & GianMaria Brambilla

  3. Istituto Auxologico Italiano, Milan, Italy

    Gino Seravalle

Authors
  1. Guido Grassi
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  2. GianMaria Brambilla
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  3. Daniela Prata Pizzalla
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  4. Gino Seravalle
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Corresponding author

Correspondence to Guido Grassi.

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Conflict of Interest

Drs. Grassi, Brambilla, Pizzalla and Seravalle declare no conflicts of interest relevant to this manuscript.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Secondary Hypertension: Nervous System Mechanisms

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Grassi, G., Brambilla, G., Pizzalla, D.P. et al. Baroreflex Activation Therapy in Congestive Heart Failure: Novel Findings and Future Insights. Curr Hypertens Rep 18, 60 (2016). https://doi.org/10.1007/s11906-016-0667-0

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  • DOI: https://doi.org/10.1007/s11906-016-0667-0

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