Abstract
The cardiovascular continuum from the hypertensive state to decompensated heart failure has seen in the last decade a great improvement not only in pharmacological therapy but also in the device-based treatment. This aspect is particularly evident for the great development of devices useful to improve contractility and hemodynamic of the heart and for the important evolution in left ventricular assist devices. In hypertensive patients, the evolution has been concentrated on devices capable of interfering with the pathophysiologic mechanisms that sustain blood pressure, i.e., adrenergic tone and baroreflex mechanism. The chapter will briefly depict the principal innovative devices developed for treating these pathophysiologic conditions.
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References
Mancia G, Grassi G, Giannattasio C, Seravalle G. Sympathetic activation in the pathogenesis of hypertension and progression of organ damage. Hypertension. 1999;34:724–8.
Seravalle G, Lonati L, Buzzi S, et al. Sympathetic nerve traffic and baroreflex function in optimal, normal, and high-normal blood pressure states. J Hypertens. 2015;33:1411–7.
Grassi G, Pisano A, Bolignano D, et al. Sympathetic nerve traffic activation in essential hypertension and its correlates. Systematic reviews and meta-analyses. Hypertension. 2018;72:483–91.
Grassi G, Seravalle G, Brambilla G, et al. Marked sympathetic activation and baroreflex dysfunction in true resistant hypertension. Int J Cardiol. 2014;177:1020–5.
Seravalle G, Quarti-Trevano F, Dell’Oro R, et al. Sympathetic and baroreflex alterations in congestive heart failure with preserved, midrange and reduced ejection fraction. J Hypertens. 2019;37:443–8.
Grassi G, D’Arrigo G, Pisano A, et al. Sympathetic neural overdrive in congestive heart failure and its correlates: systematic reviews and meta-analysis. J Hypertens. 2019;37:1746–56.
Go AS, Mozaffarian D, Roger VL, et al. American Heart Association statistics committee and stroke statistic subcommittee. Heart disease and stroke statistics-2014 update: a report from the American Heart Association. Circulation. 2014;129:e28–292.
Krum H, Schlaich M, Withbourn R, et al. Catheter-based renal sympathetic denervation for resistant hypertension: a multicenter safety and proof-of-principle cohort study. Lancet. 2009;373:1275–81.
Seravalle G, Dell’Oro R, Grassi G. Baroreflex activation therapy systems: current status and future prospects. Expert Rev Med Devices. 2019;16:1025–33.
Bisognano JD, Bakris G, Nadim MK, et al. Baroreflex activation therapy lowers blood pressure in patients with resistant hypertension: results from double-blind, randomized, placebo-controlled Rheos pivotal trial. J Am Coll Cardiol. 2011;58:765–73.
Bakris GL, Nadim MK, Haller H, et al. Baroreflex activation therapy provides durable benefit in patients with resistant hypertension: results of long-term follow-up in the Rheos pivotal trial. J Am Soc Hypertens. 2012;6:152–8.
Hoppe UC, Brandt MC, Watcher R, et al. Minimally invasive system for baroreflex activation therapy chronically lowers blood pressure with pacemaker-like safety profile: results from the Barostim neo trial. J Am Soc Hypertens. 2012;6:270–6.
Zile MR, Abraham WT, Weaver FA, et al. Baroreflex activation therapy for the treatment of heart failure with a reduced ejection fraction: safety and efficacy in patients with and without cardiac resynchronization therapy. Eur J Heart Fail. 2015;17:1066–74.
Gronda E, Seravalle G, Quarti-Trevano F, et al. Long-term chronic baroreflex activation: persistent efficacy in patients with heart failure and reduced ejection fraction. J Hypertens. 2015;33:1704–8.
Grassi G, Brambilla G, Prata Pizzalla D, Seravalle G. Baroreflex activation therapy in congestive heart failure: novel findings and future insights. Curr Hypertens Rep. 2016;18:60.
DiBona GF, Kopp UC. Neural control of renal function. Physiol Rev. 1997;77:75–197.
Stella A, Zanchetti A. Functional role of renal afferents. Physiol Rev. 1991;71:659–82.
Lohmeier TE, Irwin ED, Rossing MA, et al. Prolonged activation of the baroreflex produces sustained hypotension. Hypertension. 2004;43:306–11.
Seravalle G, Grassi G. Carotid baroreceptor stimulation in resistant hypertension and heart failure. High Blood Press Cardiovasc Prev. 2015;22:233–9.
Esler MD, Krum H, Sobotka PA, Symplicity HTN-2 Investigators, et al. Renal sympathetic denervation in patients with treatment resistant hypertension: a randomized controlled trial. Lancet. 2010;376:1903–9.
Krum H, Schlaich MP, Sobotka PA, et al. Percutaneous renal denervation in patients with treatment-resistant hypertension: final 3-year report of the symplicity HTN-1 study. Lancet. 2014;383:622–9.
Esler MD, Bohm M, Sievert H, et al. Catheter-based renal denervation for treatment of patients with treatment-resistant hypertension: 36 months results from the symplicity HTN-2 randomized clinical trial. Eur Heart J. 2014;35:1752–9.
Bhatt DL, Kandzari DE, O’Neill WW, Symplicity HTN-3 Investigators, et al. A controlled trial of renal denervation for resistant hypertension. N Engl J Med. 2014;370:1393–401.
Bhatt DL, Bakris GL. Renal denervation for resistant hypertension. N Engl J Med. 2014;371:184.
Weber MA, Schiffrin EL, White WB, et al. Clinical practice guidelines for the management of hypertension in the community: a statement by the American Society of Hypertension and the International Society of Hypertension. J Clin Hypertens. 2014;16:14–26.
Ott C, Schmieder RE. Invasive treatment of resistant hypertensin: present and future. Curr Hypertens Rep. 2014;16:488.
Whitbourn R, Harding SA, Walton A. Symplicity multi-electrode radiofrequency renal denervation system feasibility study. EuroIntervention. 2015;11:104–9.
Mahfoud F, Mancia G, Schmieder R, et al. Renal denervation in high-risk patients with hypertension. J Am Coll Cardiol. 2020;75:2879–88.
Persu A, Jin Y, Azizi M, et al. European Network COordinating Research on Renal Denervation (ENCOReD). Blood pressure changes after renal denervation at 10 European expert centers. J Hum Hypertens. 2014;28:150–6.
Mahfoud F, Ukena C, Schmieder RE, et al. Ambulatory blood pressure changes after renal sympathetic denervation in patients with resistant hypertension. Circulation. 2013;128:132–40.
Vogel B, Kirchberger M, Zeier M, et al. Renal sympathetic denervation therapy in the real world: results from the Heidelberg registry. Clin Res Cardiol. 2014;103:117–24.
Hering D, Mahfoud F, Walton AS, et al. Renal denervation in moderate to severe CKD. J Am Soc Nephrol. 2021;23:1250–7.
Ott C, Mahfoud F, Schmid A, et al. Renal denervation in moderate treatment-resistant hypertension. J Am Coll Cardiol. 2013;62:1880–6.
Papademetriou V, Tsioufis CP, Sinhal A, et al. Catheter-based renal denervation for resistant hypertension: 12-months results of the EnligHTN 1 first-in-human study using a multielectrode ablation system. Hypertension. 2014;64:565–72.
Sievert H, Schofer J, Ormiston J, et al. Bipolar radiofrequency renal denervation with the Vessix catheter in patients with resistant hypertension: 2-year results from the REDUCE-HTN trial. J Hum Hypertens. 2017;31:366–8.
Verheye S, Ormiston J, Bergmann MW, et al. Twelve-month results of the rapid renal sympathetic denervation for resistant hypertension using the OneShot™ ablation system (RAPID) study. EuroIntervention. 2015;10:1221–9.
Daemen J, Mahfoud F, Kuck KH, et al. Safety and efficacy of endovascular ultrasound renal denervation in resistant hypertension: 12-month results from the ACHIEVE study. J Hypertens. 2019;37:1906–12.
Chernin G, Szwarcfiter I, Steinert D, et al. First-in-man experience with a novel catheter-based renal denervation system of ultrasonic ablation in patients with resistant hypertension. J Vasc Interv Radiol. 2018;29:1158–66.
Fischell TA, Ebner A, Gallo S, et al. Transcatheter alcohol-mediated perivascular renal denervation with the peregrine system: first-in-human experience. JACC Cardiovasc Interv. 2016;9:589–98.
Heuser RR, Mahtre AU, Buelna TJ, et al. A novel non-vascular system to treat resistant hypertension. EuroIntervention. 2013;9:135–9.
Ormiston JA, Anderson T, Brinton TJ, et al. TCT-412 non-invasive renal denervation using externally delivered focused ultrasound: early experience using Doppler based imaging tracking and targeting for treatment. J Am Coll Cardiol. 2014;64:11-S. https://doi.org/10.1016/j.jacc.2014.07.461.
Schmieder RE, Ott C, Toennes SW, et al. Phase II randomized sham-controlled study of renal denervation for individuals with uncontrolled hypertension—WAVE IV. J Hypertens. 2018;36:680–9.
Kroon A, Schmidli J, Sheffers I, et al. Chronically implanted system: 4-year data of Rheos DEBuT-HT study in patients with resistant hypertension. J Hypertens. 2012;28(suppl A):e441.
Heusser K, Tank J, Engeli S, et al. Carotid baroreceptor stimulation, sympathetic activity, baroreflex function, and blood pressure in hypertensive patients. Hypertension. 2010;55:619–26.
Bakris GL, Nadim MK, Haller H, et al. Baroreflex activation therapy provides durable benefits in patients with resistant hypertension: results of long-term follow up in the Rheos pivotal trial. J Am Soc Hypertens. 2012;6:152–8.
Wallbach M, Lehning LY, Schroer C, et al. Effects of baroreflex activation therapy on ambulatory blood pressure in patients with resistant hypertension. Hypertension. 2016;67:701–9.
Spiering W, Williams B, van der Heyden J, CALM-FIM-EUR Investigators, et al. Endovascular baroreflex amplification for resistant hypertension: a safety and proof-of-principle clinical study. Lancet. 2017;390:2655–61.
Foran JP, Jain AK, Casserly JP, et al. The ROX coupler: creation of a fixed iliac arteriovenous anastomosis for the treatment of uncontrolled systemic arterial hypertension, exploiting the physical properties of the arterial vasculature. Catheter Cardiovasc Interv. 2015;85:880–6.
Burchell AE, Lobo MD, Sulke N, et al. Arteriovenous anastomosis: is this the way to control hypertension? Hypertension. 2014;64:6–12.
Kapil V, Sobotka PA, Saxena M, et al. Central iliac arteriovenous anastomosis for hypertension: targeting mechanical aspects of the circulation. Curr Hypertens Rep. 2015;17:585.
Lobo MD, Sobotka PA, Stanton A, et al. Central arteriovenous anastomosis for the treatment of patients with uncontrolled hypertension (the ROX CONTROL HTN study): a randomized controlled trial. Lancet. 2015;385:1634–41.
Li P, Tjen-A-Looi SC, Cheng L, et al. Long-lasting reduction of blood pressure by electro-acupuncture in patients with hypertension: randomized controlled trial. Med Acupunct. 2015;27:253–66.
Annoni EM, Xie X, Lee SW, et al. Intermittent electrical stimulation of the right cervical vagus nerve in salt-sensitive hypertensive rats: effects on blood pressure, arrhythmias, and ventricular electrophysiology. Physiol Rep. 2015;3:e12476.
Gierthmuehlen M, Plachta DT. Effects of selective vagal nerve stimulation on blood pressure, heart rate and respiratory rate in rats under metoprolol medication. Hypertens Res. 2016;39:79–87.
Mirkovic T, Knezevic I, Radan I, et al. Frequency dependent effect of selective biphasic left vagus nerve stimulation on heart rate and arterial pressure. Signa Vitae. 2012;7:63–8.
Davies JE, Manisty CH, Petraco E, et al. First-in-man safety evaluation of renal denervation for chronic systolic heart failure: primary outcome from REACH-pilot study. Int J Cardiol. 2013;162:189–92.
Patel HC, Rosen SD, Hayward C, et al. Renal denervation in heart failure with preserved ejection fraction (RDT-PEF): a randomized controlled trial. Eur J Heart Fail. 2016;18:703–12.
Dai Q, Lu J, Wang B, Ma G. Effect of percutaneous renal sympathetic nerve radiofrequency ablation in patients with severe heart failure. Int J Clin Exp Med. 2015;8:9779–85.
Chen W, Ling Z, Xu Y, et al. Preliminary effects of renal denervation with saline irrigated catheter on cardiac systolic function in patients with heart failure: a prospective, randomized, controlled, pilot study. Catheter Cardiovasc Interv. 2017;89:E153–61.
Gao JQ, Xie Y, Yang W, et al. Effects of percutaneous renal sympathetic denervation on cardiac function and exercise tolerance in patients with chronic heart failure. Rev Port Cardiol. 2017;36:45–51.
Fukuta H, Goto T, Wakami K, Ohte N. Effects of catheter-based renal denervation on heart failure with reduced ejection fraction: a systematic review and meta-analysis. Heart Fail Rev. 2017;22:657–64.
Lu Y, Zhang L, Zhou X, Tang B. Renal sympathetic denervation: a potential alternative strategy for patients with heart failure. Int J Cardiol. 2015;201:140–1.
Gronda E, Seravalle G, Brambilla G, et al. Chronic baroreflex activation effects on sympathetic nerve traffic, baroreflex function and cardiac haemodynamics in heart failure. A proof-of-concept study. Eur J Heart Fail. 2014;16:977–83.
Abraham WT, Zile MR, Weaver FA, et al. Baroreflex activation therapy for the treatment of heart failure with a reduced ejection fraction. J Am Coll Cardiol Heart Fail. 2015;3:487–96.
Hallbach M, Abraham WT, Butter C, et al. Baroreflex activation therapy for the treatment of heart failure with reduced ejection fraction in patients with and without coronary artery disease. Int J Cardiol. 2018;266:187–92.
Dell’Oro R, Gronda G, Seravalle G, et al. Restoration of normal sympathetic neural function in heart failure following baroreflex activation therapy: final 43-month study report. J Hypertens. 2017;35:2532–6.
Zile MR, Bennett TD, St John Sutton M, et al. Transition from chronic compensated to acute decompensated heart failure: pathophysiological insights obtained from continuous monitoring of intracardiac pressures. Circulation. 2008;118:1433–41.
Barnes RJ, Bower EA, Rink TJ. Haemodynamic responses to stimulation of the splanchnic and cardiac sympathetic nerves in the anaesthetized cat. J Physiol. 1986;378:417–36.
Fudim M, Ganesh A, Green C, et al. Splanchnic nerve block for decompensated chronic heart failure: splanchnic-HF. Eur Heart J. 2018;39:4255–6.
Fudim M, Jones WS, Boortz-Marx RL, et al. Splanchnic nerve block for acute heart failure. Circulation. 2018;138:951–3.
Sondegaard L, Reddy V, Kaye D, et al. Transcatheter treatment of heart failure with preserved or mildly reduced ejection fraction using a novel interatrial implant to lower left atrial pressure. Eur J Heart Fail. 2014;16:796–801.
Hasenfuß G, Hayward C, Burkhoff D, et al. A transcatheter intracardiac shunt device for heart failure with preserved ejection fraction (REDUCE LAP-HF): a multicenter, open-label, single arm, phase 1 trial. Lancet. 2016;387:1298–304.
Del Trigo M, Bergeron S, Bernier M, et al. Unidirectional left-to-right interatrial shunting for treatment of patients with heart failure with reduced ejection fraction: a safety and proof-of-principle cohort study. Lancet. 2016;387:1290–7.
Rodes-Cabau J, Bernier M, Amat-Santos IJ, et al. Interatrial shunting for heart failure: early and late results from the first-in-human experience with the V-Wave system. J Am Coll Cardiol Interv. 2018;11:2300–10.
Guimaraes L, Bergeron S, Bernier M, et al. Interatrial shunt with the second generation V-Wave system for patients with advanced chronic heart failure. EuroIntervention. 2002;15:1426–8.
Patel MB, Samuel BO, Girgis RE, et al. Implantable atrial flow regulator for severe, irreversible pulmonary arterial hypertension. EuroIntervention. 2015;11:706–9.
Rajeshkumar R, Pavithran S, Sivakumar K, et al. Atrial septostomy with a predefined diameter using a novel occlutech atrial flow regulator improves symptoms and cardiac index in patients with severe pulmonary arterial hypertension. Catheter Cardiovasc Interv. 2017;9:1145–53.
Paitazoglou C, Bergmann MW, Ozdemir R, et al. One year results of the first-in-man study investigating the atrial flow regulator for left atrial shunting in symptomatic heart failure patients: the PRELIEVE study. Eur J Heart Fail. 2021;23:800–10.
Simard T, Labinaz M, Zahr R, et al. Percutaneous atriotomy for levoatrial-to-coronary sinus shunting in symptomatic heart failure: first-in-human experience. J Am Coll Cardiol Interv. 2020;13:1236–47.
Feld Y, Dubi S, Reisner Y, et al. Future strategies for the treatment of diastolic heart failure. Acute Card Care. 2006;8:13–20.
Feld Y, Dubi S, Reisner Y, et al. Energy transfer from systole to diastole: a novel device-based approach for the treatment of diastolic heart failure. Acute Card Care. 2011;13:232–42.
ImCardia TM for DHF to Treat Diastolic Heart Failure (DHF) Patient a Pilot Study (ImCardia). https://clinicaltrials.gov/ct2/show/NCT01347125. Accessed 1 May 2021.
Feld Y, Reisner Y, Meyer-Brodnitz G, et al. The CORolla device for energy transfer from systole to diastole: a novel treatment for heart failure with preserved ejection fraction. Heart Fail Rev. 2021;28:307. https://doi.org/10.1007/s10741-021-10104-x.
CORolla TAA for Heart Failure With Preserved Ejection Fraction (HFpEF) and Diastolic Dysfunction (DD). https://clinicaltrials.gov/ct2/show/NCTO2499601. Accessed 1 May 2021.
Borggrefe M, Mann DL. Cardiac contractility modulation in 2018. Circulation. 2018;138:2738–40.
Imai M, Rastogi S, Gupta RC, et al. Therapy with cardiac contractility modulation electrical signals improves left ventricular function and remodeling in dogs with chronic heart failure. J Am Coll Cardiol. 2007;49:2120–8.
Kuschyk J, Roger S, Schneider R, et al. Efficacy and survival in patients with cardiac contractility modulation: long-term single center experience in 81 patients. Int J Cardiol. 2015;183:76–81.
Abraham WT, Kuck K-H, Goldsmith RL, et al. A randomized controlled trial to evaluate the safety and efficacy of cardiac contractility modulation. JACC Heart Fail. 2018;6:874–83.
Abraham WT. Cardiac resynchronization therapy. In: Semirgran M, Shin JT, editors. Heart failure. 2nd ed. CRC Press; 2012.
Auricchio A, Stelibrink C, Sack S, et al. Long-term clinical effect of hemodynamically optimized cardiac resynchronization therapy in patients with heart failure and ventricular conduction delay. J Am Coll Cardiol. 2002;39:2026–33.
Bradley DJ, Bradley EA, Baughman KL, et al. Cardiac resynchronization and death from progressive heart failure: a meta-analysis of randomized controlled trials. JAMA. 2003;289:730–40.
Cleland JG, Daubert JC, Erdmann E, et al. The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med. 2005;352:1539–49.
St John Sutton MG, Plappert T, Abraham WT, et al. Effects of cardiac resynchronization therapy on left ventricular size and function in chronic heart failure. Circulation. 2003;107:1985–90.
Moss AJ, Hall WJ, Cannon DS, et al. Cardiac resynchronization therapy for the prevention of heart failure events. N Engl J Med. 2009;361:1329–38.
McAlister FA, Ezekowitz J, Hoorton N, et al. Cardiac resynchronization therapy for patients with left ventricular systolic dysfunction: a systematic review. JAMA. 2007;297:2502–14.
McDonagh TA, Metra M, Adamo M, et al. 2021 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2021;42:3599–726.
Miller LW, Rogers JG. Evolution of left ventricular assist device therapy for advanced heart failure. A review. JAMA Cardiol. 2018;3:650–8.
Frigerio M. Left ventricular assist device. Indication, timing, and management. Heart Fail Clin. 2021;17:619–34.
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Gino, S., Grassi, G. (2023). Device-Based Treatment in Hypertension and Heart Failure. In: Dorobantu, M., Voicu, V., Grassi, G., Agabiti-Rosei, E., Mancia, G. (eds) Hypertension and Heart Failure. Updates in Hypertension and Cardiovascular Protection. Springer, Cham. https://doi.org/10.1007/978-3-031-39315-0_27
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