Renal denervation gives better outcomes than drugs in advanced heart failure

August 27, 2012

Renal denervation leads to better outcomes than standard drug treatment in patients with advanced heart failure, according to research presented at ESC Congress 2012. The results of the Olomouc I pilot study were presented by Dr Miloš Táborský from the University Hospital Olomouc.

Renal does not involve any pharmacological treatment. It is a multiple application of radiofrequency energy using a thin via the and a long-term "denervation" of the around the renal arteries. "This is done to prevent an increased of the substances leading to heart failure," said Dr Táborský.

The aim of this pilot study was to compare the outcomes of patients with advanced heart failure receiving standard pharmacological treatment or renal denervation. Over the period of one year, 26 patients were treated with renal denervation and standard and 25 patients received standard drug treatment with beta-blockers, or ARBs and diuretics.

After one year contractile function of the left side of the heart improved in patients treated with renal denervation from 25±12% to 31±14% (p<0.01).

There was no change in contractile function of the left side of the heart in patients who received standard drug treatment. "The improvement of the contractile function of the left side of the heart by more than 10% in patients after renal denervation was a surprise," said Dr Táborský. "This parameter has practically not changed in patients treated by the classic drugs. The difference in response might be explained by a continuous decrease of the renal sympathetic activity in the complex pathophysiology of heart failure."

During the one year follow-up, 8 patients treated with renal denervation were hospitalized due to heart failure compared to 18 patients treated with standard drug therapy. Dr Táborský said: "Twice the number of patients treated by classic pharmacological therapy were taken to hospital due to heart failure."

The disadvantage of denervation, as with any invasive treatment, is the potential for subsequent complications. "We have registered two complications – the formation of a fistula by the artery and the vein in the place of puncture and the formation of thrombi despite all safety measures being adhered to," said Dr Táborský. "We have successfully removed both complications by a surgical revision and thromboaspiration."

The findings indicate that renal denervation may be a non-pharmacological alternative for the treatment of patients with advanced and may help stabilise the disease. "Renal denervation is particularly suited for patients without an extensive scar after myocardial infarction and whose heart rate increases when they are treated with the maximum tolerated dose of beta-blockers," added Dr Táborský.

He concluded: "The long-term effects of renal denervation should be confirmed in a large international randomised study."

Explore further: Study tests new therapy for treatment-resistant hypertension

More information: Symplicity HTN-2 Investigators, Esler MD, Krum H, Sobotka PA, Schlaich MP, Schmieder RE, Böhm M. Renal sympathetic denervation in patients with treatment-resistant hypertension (The Symplicity HTN-2 Trial): a randomised controlled trial. Lancet. 2010;376:1903-1909

Related Stories

Study tests new therapy for treatment-resistant hypertension

June 28, 2012
(Medical Xpress) -- Treatment-resistant hypertension affects nearly 6 million Americans and another 94 million people worldwide and is associated with increased cardiovascular risk, including stroke and heart attack, as well ...

Simple procedure lowers blood pressure in kidney disease patients

May 17, 2012
Disrupting certain nerves in the kidneys can safely and effectively lower blood pressure in patients with chronic kidney disease (CKD) and hypertension, according to a study appearing in an upcoming issue of the Journal of ...

Canada's first renal denervation procedure to reduce high blood pressure performed today

January 17, 2012
Doctors at the Peter Munk Cardiac Centre today performed a minimally invasive surgical procedure to treat high blood pressure, called renal denervation, for the first time in Canada. The procedure can significantly reduce ...

Recommended for you

Low-salt and heart-healthy dash diet as effective as drugs for some adults with high blood pressure

November 22, 2017
A study of more than 400 adults with prehypertension, or stage 1 high blood pressure, found that combining a low-salt diet with the heart-healthy DASH diet substantially lowers systolic blood pressure—the top number in ...

Stroke patients may have more time to get treatment, study finds

November 22, 2017
Patients and doctors long have relied on a simple rule of thumb for seeking care after an ischemic stroke: "Time is brain."

Cases of heart failure continue to rise; poorest people worst affected

November 22, 2017
The number of people being diagnosed with heart failure in the UK continues to rise as a result of demographic changes common to many developed countries, new research by The George Institute for Global Health at the University ...

Some cancer therapies may provide a new way to treat high blood pressure

November 20, 2017
Drugs designed to halt cancer growth may offer a new way to control high blood pressure (hypertension), say Georgetown University Medical Center investigators. The finding could offer a real advance in hypertension treatment ...

Could this protein protect people against coronary artery disease?

November 17, 2017
The buildup of plaque in the heart's arteries is an unfortunate part of aging. But by studying the genetic makeup of people who maintain clear arteries into old age, researchers led by UNC's Jonathan Schisler, PhD, have identified ...

Raising 'good' cholesterol fails to protect against heart disease

November 16, 2017
Raising so-called 'good' cholesterol by blocking a key protein involved in its metabolism does not protect against heart disease or stroke, according to a large genetic study of 150,000 Chinese adults published in the journal ...

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.