Abstract
Background: Baroreflex activation therapy (BAT) modulates sympathovagal balance, which is deranged in patients with heart failure leading to increased morbidity and mortality. Our aim was to study the effect of BAT on levels of the prognostic markers NTproBNP, NYHA class and 6-Minute Walk Test in patients with heart failure and reduced ejection fraction. Methods: 6 Patients were implanted with the CVRx Barostim neoTM system (CVRx Inc., Minneapolis, Minnesota) at the University of Cologne as part of a first-in-man study of BAT for systolic heart failure. They had an ejection fraction <35% and were in NYHA class III before BAT (inclusion criteria). NTproBNP measurements and 6-Minute Walk Tests were performed prior to implantation and repeatedly during follow-up. NTproBNP was quantified as the average of all available values within 3 month before implantation and after activation of the device. All data are presented as mean±SEM. Results: NTproBNP was 2797±971 ng/l prior to BAT and fell to 1435±398 ng/l during an average follow-up of 9.4 months (p=0.07). 6-Minute Walk Distance improved from 314±42 m to 366±25 m (p<0.05). NYHA class decreased from 3.0±0.0 to 2.7±0.2 (p=0.08). There were no serious adverse events with definite or probable relation to the procedure or device. Conclusions: These preliminary, first-in-man data indicate that BAT lowers levels of NTproBNP in patients with systolic heart failure and improves 6-Minute Walk Test and NYHA functional class. These findings suggest that BAT may improve clinical status and possibly prognosis in heart failure patients. These promising initial results encourage pursuing the study of BAT in patients with heart failure.
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