The efficacy of renal sympathetic denervation as a treatment for heart failure
DOI:
https://doi.org/10.11606/issn.1679-9836.v102i5e-187827Keywords:
Sympathectomy, Denervation, Heart FailureAbstract
Heart failure (HF) has become increasingly frequent in the population, due the importance of this disease worldwide so several studies evaluate new treatment options, such as renal sympathetic denervation (RDN), to inhibit kidney-stimulated cardiac activation. The aim of this study is to understand whether RDN is a feasible treatment for heart failure and its advantages. An integrative literature review was conducted with a search in the PubMed and Scielo databases, using the descriptors "Sympathectomy", "Denervation" and "Heart failure", found in DeCS. We searched for articles published in the last 10 years, in English, Spanish and Portuguese, available in full, excluding studies with experimental models. A total of 188 articles were found and of these 23 were selected, which have demonstrated relevance to the objective of the article. RDN consists of interrupting the renal nerve, suppressing sympathetic activity and the renin-angiotensin-aldosterone system. Despite being a delicate technique, RDN is safe, presenting complications inherent to invasive procedures, however of low to moderate severity, and few adverse effects. Thus, RDN proved to be a promising treatment for HF, promoting the remission of important symptoms, but it did not represent a cure for this disease.
Downloads
References
Ponikowski P, Voors A, Anker S, et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2016;37(27):2129-2200. doi: https://doi.org/10.1093/eurheartj/ehw128
Ziaeian B, Fonarow G. Epidemiology and aetiology of heart failure. Nature Rev Cardiol. 2016;13(6):368-378. doi: https://doi.org/10.1038/nrcardio.2016.25
Kiuchi M, Nolde J, Villacorta H, et al. New Approaches in the Management of Sudden Cardiac Death in Patients with Heart Failure—Targeting the Sympathetic Nervous System. Int J Molr Sci. 2019;20(10):2430. doi: https://doi.org/10.3390/ijms20102430
Borovac J, D'Amario D, Bozic J, Glavas D. Sympathetic nervous system activation and heart failure: Current state of evidence and the pathophysiology in the light of novel biomarkers. World J Cardiol. 2020;12(8):373-408. doi: https://doi.org/10.4330/wjc.v12.i8.373
Parati G, Esler M. The human sympathetic nervous system: its relevance in hypertension and heart failure. Eur Heart J. 2012;33(9):1058-1066. doi: https://doi.org/10.1093/eurheartj/ehs041
Rexel T, Bertog S, Vaskelyte L, Sievert H. Renal denervation. Anadolu Kardiyoloji Dergisi/The Anatolian. J. cardiol. 2014;14(2):186-191. doi: https://doi.org/10.5152/akd.2014.5294
Hoogerwaard A, Elvan A. Is renal denervation still a treatment option in cardiovascular disease?. Trends cardiovasc. med. 2020;30(4):189-195. doi: https://doi.org/10.1016/j.tcm.2019.05.006
Staico, R., Armaganijan, L., Moreira, D. et al. Denervação simpática renal: um novo cateter em um novo cenário. Rev. bras. cardiol. invasiva. 2012;21(4):396-400. doi: https://doi.org/10.1590/S2179-83972013000400016
Geng, J., Chen, C., Zhou, X., Qian, W. and Shan, Q. Influence of Renal Sympathetic Denervation in Patients with Early-Stage Heart Failure Versus Late-Stage Heart Failure. Int. heart j. 2018;59(1):99-104. doi: https://doi.org/10.1536/ihj.16-413
Singh, J., Kandala, J. and John Camm, A. Non-pharmacological modulation of the autonomic tone to treat heart failure. Eur Heart J. 2013;35(2):77-85. doi: https://doi.org/10.1093/eurheartj/eht436
Floras, J. Arterial Baroreceptor and Cardiopulmonary Reflex Control of Sympathetic Outflow in Human Heart Failure. Ann. N. Y. Acad. sci. 2006;940(1):500-513. doi: https://doi.org/10.1111/j.1749-6632.2001.tb03701.x
Chatterjee, N. and Singh, J. Novel Interventional Therapies to Modulate the Autonomic Tone in Heart Failure. JACC: Heart Failure. 2015;3(10):786-802. doi: https://doi.org/10.1016/j.jchf.2015.05.008
Kishi, T. Deep and future insights into neuromodulation therapies for heart failure. J. cardiol. 2016;68(5):368-372. doi: https://doi.org/10.1016/j.jjcc.2016.05.010
Kishi, T. Heart Failure as a Disruption of Dynamic Circulatory Homeostasis Mediated by the Brain. Int. heart j. 2016;57(2):145-149. doi: https://doi.org/10.1536/ihj.15-517
Hasking, G., Esler, M., Jennings, G., Burton, D., Johns, J. and Korner, P. Norepinephrine spillover to plasma in patients with congestive heart failure: evidence of increased overall and cardiorenal sympathetic nervous activity. Circulation. 1986;73(4):615-621. doi: https://doi.org/10.1161/01.cir.73.4.615
Petersson, M., Friberg, P., Eisenhofer, G., Lambert, G. and Rundqvist, B. Long-term outcome in relation to renal sympathetic activity in patients with chronic heart failure. Eur Heart J. 2005;26(9):906-913. doi: https://doi.org/10.1093/eurheartj/ehi184
Pascual-Figal, D. Neprilysin and Heart Failure. J. Am. Coll. Cardiol. 2017;70(17):2154-2156. doi: https://doi.org/10.1016/j.jacc.2017.09.003
McArdle, M., deGoma, E., Cohen, D., Townsend, R., Wilensky, R. and Giri, J. Beyond Blood Pressure: Percutaneous Renal Denervation for the Management of Sympathetic Hyperactivity and Associated Disease States. J. Am. Heart Assoc. 2015;4(3):e001415. doi: https://doi.org/10.1161/JAHA.114.001415
Böhm, M., Ewen, S., Kindermann, I., Linz, D., Ukena, C. and Mahfoud, F. Renal denervation and heart failure. Eur. j. heart fail. 2014;16(6):608-613. doi: https://doi.org/10.1002/ejhf.83
Böhm, M., Ewen, S., Linz, D., et al. Therapeutic potential of renal sympathetic denervation in patients with chronic heart failure. EuroIntervention. 2013;9:122-126. doi: https://doi.org/10.4244/EIJV9SRA21
Sobotka, P., Mahfoud, F., Schlaich, M., Hoppe, U., Böhm, M. and Krum, H. Sympatho-renal axis in chronic disease. Clin. res. Cardiol. 2011;100(12):1049-1057. doi: https://doi.org/10.1007/s00392-011-0335-y
Gao, J., Yang, W. and Liu, Z. Percutaneous renal artery denervation in patients with chronic systolic heart failure: A randomized controlled trial. Cardiol j. 2019;26(5):503-510. doi: https://doi.org/10.5603/CJ.a2018.0028
Patel, H., Rosen, S., Hayward, C. et al. Renal denervation in heart failure with preserved ejection fraction (RDT-PEF): a randomized controlled trial. Eur. j. heart fail. 2016;18(6):703-712. doi: https://doi.org/10.1002/ejhf.502
Shen, M. and Zipes, D. Interventional and Device-Based Autonomic Modulation in Heart Failure. Heart fail. clin. 2015;11(2):337-348. doi: https://doi.org/10.1016/j.hfc.2014.12.010
Gao, J., Xie, Y., Yang, W., Zheng, J. and Liu, Z. Effects of percutaneous renal sympathetic denervation on cardiac function and exercise tolerance in patients with chronic heart failure. Rev. port. cardiol. 2017;36(1):45-51. doi: https://doi.org/10.1016/j.repc.2016.07.007
Bhat, A., Kuang, Y., Gan, G., Burgess, D. and Denniss, A. An Update on Renal Artery Denervation and Its Clinical Impact on Hypertensive Disease. BioMed res. int. 2015;2015:1-9. doi: https://doi.org/10.1155/2015/607079
Hoogerwaard, A. and Elvan, A. Is renal denervation still a treatment option in cardiovascular disease?. Trends cardiovasc. med. 2020;30(4):189-195. doi: https://doi.org/10.1016/j.tcm.2019.05.006
Verloop W, Beeftink M, Nap A et al. Renal denervation in heart failure with normal left ventricular ejection fraction. Rationale and design of the DIASTOLE (DenervatIon of the renal Sympathetic nerves in heart failure with normal Lv Ejection fraction) trial. Eur. j. heart fail. 2013;15(12):1429-1437. doi: https://doi.org/10.1093/eurjhf/hft119
Schwartz, P., La Rovere, M., De Ferrari, G. and Mann, D. Autonomic Modulation for the Management of Patients with Chronic Heart Failure. Circ. Heart fail. 2015;8(3):619-628. doi: https://doi.org/10.1161/CIRCHEARTFAILURE.114.001964
Kanai, T. and Krum, H. New Treatment for Old Disease: Management of Resistant Hypertension by Percutaneous Renal Sympathetic Denervation. Rev. esp. de cardiol. (Internet. Engl. ed.). 2013;66(9):734-740. doi: https://doi.org/10.1016/j.rec.2013.06.001
Froeschl, M., Hadziomerovic, A. and Ruzicka, M. Percutaneous Renal Sympathetic Denervation: 2013 and Beyond. Can. j. cardiol. 2014;30(1):64-74. doi: https://doi.org/10.1016/j.cjca.2013.11.003
Berukstis, A., Vajauskas, D., Gargalskaite, U. et al. Impact of renal sympathetic denervation on cardiac sympathetic nerve activity evaluated by cardiac MIBG imaging. EuroIntervention. 2016;11(9):1070-1076. doi: https://doi.org/10.4244/EIJV11I9A215
Yang, J., Choi, S. and Gwon, H. Percutaneous Renal Sympathetic Denervation for the Treatment of Resistant Hypertension with Heart Failure: First Experience in Korea. J. Korean Med. Sci. 2013;28(6):951. doi: https://doi.org/10.3346/jkms.2013.28.6.951
Schlaich M. Renal Sympathetic Denervation: A Viable Option for Treating Resistant Hypertension. Am. j. hypertens. 2017;30(9):847-856. doi: https://doi.org/10.1093/ajh/hpx033
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Elany Maria Ferreira Portela, Jeanne Beatriz Nunes da Silva, Laís Emanuelle Lamounier, Lara Kaiulani Lamounier , Talitha Araújo Velôso Faria
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
