Premium
Renal denervation in heart failure with preserved ejection fraction ( RDT‐PEF ): a randomized controlled trial
Author(s) -
Patel Hitesh C.,
Rosen Stuart D.,
Hayward Carl,
Vassiliou Vassilios,
Smith Gillian C.,
Wage Ricardo R.,
Bailey James,
Rajani Ronak,
Lindsay Alistair C.,
Pennell Dudley J.,
Underwood S. Richard,
Prasad Sanjay K.,
Mohiaddin Raad,
Gibbs J. Simon R.,
Lyon Alexander R.,
Di Mario Carlo
Publication year - 2016
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1002/ejhf.502
Subject(s) - medicine , heart failure , ejection fraction , randomized controlled trial , denervation , cardiology , heart failure with preserved ejection fraction
Abstract Aim Heart failure with preserved ejection fraction ( HFpEF ) is associated with increased sympathetic nervous system ( SNS ) tone. Attenuating the SNS with renal denervation ( RDT ) might be helpful and there are no data currently in humans with HFpEF . Methods and results In this single‐centre, randomized, open‐controlled study we included 25 patients with HFpEF [preserved left ventricular ( LV ) ejection fraction, left atrial ( LA ) dilatation or LV hypertrophy and raised B‐type natriuretic peptide ( BNP ) or echocardiographic assessment of filling pressures]. Patients were randomized (2:1) to RDT with the Symplicity™ catheter or continuing medical therapy. The primary success criterion was not met in that there were no differences between groups at 12 months for Minnesota Living with Heart Failure Questionnaire score, peak oxygen uptake ( VO 2 ) on exercise, BNP , E/e′, LA volume index or LV mass index. A greater proportion of patients improved at 3 months in the RDT group with respect to VO 2 peak (56% vs. 13%, P = 0.025) and E/e′ (31% vs. 13%, P = 0.04). Change in estimated glomerular filtration rate was comparable between groups. Two patients required plain balloon angioplasty during the RDT procedure to treat renal artery wall oedema. Conclusion This study was terminated early because of difficulties in recruitment and was underpowered to detect whether RD improved the endpoints of quality of life, exercise function, biomarkers, and left heart remodelling. The procedure was safe in patients with HFpEF , although two patients did require intraprocedure renal artery dilatation.