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Title: Left cardiac sympathetic denervation for treatment of symptomatic systolic heart failure patients: a pilot study
Authors: CONCEICAO-SOUZA, Germano EmilioPEGO-FERNANDES, Paulo ManuelCRUZ, Fatima das DoresGUIMARAES, Guilherme VeigaBACAL, FernandoVIEIRA, Marcelo Luiz CamposGRUPI, Cesar JoseGIORGI, Maria Clementina PintoCONSOLIM-COLOMBO, Fernanda MarcianoNEGRAO, Carlos EduardoRONDON, Maria Urbana P.MOREIRA, Luiz Felipe PinhoBOCCHI, Edimar Alcides
Citation: EUROPEAN JOURNAL OF HEART FAILURE, v.14, n.12, p.1366-1373, 2012
Abstract: To evaluate the feasibility, safety, and potential beneficial effects of left cardiac sympathetic denervation (LCSD) in systolic heart failure (HF) patients. In this prospective, randomized pilot study, inclusion criteria were New York Heart Association (NYHA) functional class II or III, left ventricular ejection fraction (LVEF) 40, sinus rhythm, and resting heart rate 65 b.p.m., despite optimal medical therapy (MT). Fifteen patients were randomly assigned either to MT alone or MT plus LCSD. The primary endpoint was safety, measured by mortality in the first month of follow-up and morbidity according to pre-specified criteria. Secondary endpoints were exercise capacity, quality of life, LVEF, muscle sympathetic nerve activity (MSNA), brain natriuretic peptide (BNP) levels and 24 h Holter mean heart rate before and after 6 months. We studied clinical effects in long-term follow-up. Ten patients underwent LCSD. There were no adverse events attributable to surgery. In the LCSD group, LVEF improved from 25 6.6 to 33 5.2 (P 0.03); 6 min walking distance improved from 167 35 to 198 47 m (P 0.02). Minnesota Living with Heart Failure Questionnaire (MLWHFQ) score physical dimension changed from 21 5 to 15 7 (P 0.06). The remaining analysed variables were unchanged. During 848 549 days of follow-up, in the MT group, three patients either died or underwent cardiac transplantation (CT), while in the LCSD group six were alive without CT. LCSD was feasible and seemed to be safe in systolic HF patients. Its beneficial effects warrant the development of a larger randomized trial. Trail registration: NCT01224899.
Appears in Collections:

Artigos e Materiais de Revistas Científicas - FM/MCP
Departamento de Cardio-Pneumologia - FM/MCP

Artigos e Materiais de Revistas Científicas - HC/InCor
Instituto do Coração - HC/InCor

Artigos e Materiais de Revistas Científicas - LIM/11
LIM/11 - Laboratório de Cirurgia Cardiovascular e Fisiopatologia da Circulação

Artigos e Materiais de Revistas Científicas - LIM/61
LIM/61 - Laboratório de Pesquisa em Cirurgia Torácica

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