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

Could aggressive blood pressure treatments lead to kidney damage?

July 18, 2017
Aggressive combination treatments for high blood pressure that are intended to protect the kidneys may actually be damaging the organs, new research from the University of Virginia School of Medicine suggests.

Quantifying effectiveness of treatment for irregular heartbeat

July 17, 2017
In a small proof-of-concept study, researchers at Johns Hopkins report a complex mathematical method to measure electrical communications within the heart can successfully predict the effectiveness of catheter ablation, the ...

Concerns over side effects of statins stopping stroke survivors taking medication

July 17, 2017
Negative media coverage of the side effects associated with taking statins, and patients' own experiences of taking the drugs, are among the reasons cited by stroke survivors and their carers for stopping taking potentially ...

Study discovers anticoagulant drugs are being prescribed against safety advice

July 17, 2017
A study by researchers at the University of Birmingham has shown that GPs are prescribing anticoagulants to patients with an irregular heartbeat against official safety advice.

Protein may protect against heart attack

July 14, 2017
DDK3 could be used as a new therapy to stop the build-up of fatty material inside the arteries

Heart study finds faulty link between biomarkers and clinical outcomes

July 14, 2017
Surrogate endpoints (biomarkers), which are routinely used in clinical research to test new drugs, should not be trusted as the ultimate measure to approve new health interventions in cardiovascular medicine, according to ...

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.