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baroreflex activation therapy

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https://www.readbyqxmd.com/read/29744599/endovascular-baroreflex-amplification-for-resistant-hypertension
#1
REVIEW
Monique E A M van Kleef, Mark C Bates, Wilko Spiering
PURPOSE OF REVIEW: Most hypertension devices have been designed to interrupt or modify the sympathetic nervous system, which seems to be unbalanced in hypertension. Carotid baroreceptors play a pivotal role in maintaining adrenergic balance via a direct feedback interface and would be an exceptional target for intervention. The purpose of this review is to define the role of the baroreceptor in hypertension, to examine device-based therapies targeting the baroreflex and to explore future promises of endovascular baroreflex amplification (EBA)...
May 9, 2018: Current Hypertension Reports
https://www.readbyqxmd.com/read/29744528/device-therapy-in-heart-failure-with-reduced-ejection-fraction-cardiac-resynchronization-therapy-and-more
#2
D Duncker, C Veltmann
In patients with heart failure with reduced ejection fraction (HFrEF), optimal medical treatment includes beta-blockers, ACE inhibitors/angiotensinreceptor-neprilysin inhibitors (ARNI), mineralocorticoid receptor antagonists, and ivabradine when indicated. In device therapy of HFrEF, implantable cardioverter-defibrillators and cardiac resynchronization therapy (CRT) have been established for many years. CRT is the therapy of choice (class I indication) in symptomatic patients with HFrEF and a broad QRS complex with a left bundle branch block (LBBB) morphology...
May 9, 2018: Herz
https://www.readbyqxmd.com/read/29705650/baroreflex-activation-therapy-for-the-treatment-of-heart-failure-with-reduced-ejection-fraction-in-patients-with-and-without-coronary-artery-disease
#3
Marcel Halbach, William T Abraham, Christian Butter, Anique Ducharme, Didier Klug, William C Little, Hannes Reuter, Jill E Schafer, Michele Senni, Vijay Swarup, Rolf Wachter, Fred A Weaver, Seth J Wilks, Michael R Zile, Jochen Müller-Ehmsen
BACKGROUND: In a randomized trial, baroreflex activation therapy (BAT) improved exercise capacity, quality of life and NT-proBNP in patients with heart failure with reduced ejection fraction (HFrEF). In view of different mechanisms underlying HFrEF, we performed a post-hoc subgroup analysis of efficacy and safety of BAT in patients with and without coronary artery disease (CAD). METHODS AND RESULTS: Patients with left ventricular ejection fraction <35% and NYHA Class III were randomized 1:1 to guideline-directed medical and device therapy alone or plus BAT...
April 21, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29700488/diagnosis-and-management-of-resistant-hypertension-state-of-the-art
#4
REVIEW
Fang-Fei Wei, Zhen-Yu Zhang, Qi-Fang Huang, Jan A Staessen
Resistant hypertension is defined as a lack of ambulatory blood pressure response to optimized medical treatment after exclusion of secondary hypertension in patients who are fully adherent to antihypertensive therapy. Patients with resistant hypertension are at high risk of complications, particularly cardiovascular events, and optimization of medical treatment remains the cornerstone of their management. Such optimization should be based on simple algorithms and include the use of aldosterone antagonists...
April 26, 2018: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/29677053/safety-profile-of-baroreflex-activation-therapy-neo-in-patients-with-resistant-hypertension
#5
Manuel Wallbach, Enrico Böhning, Luca-Yves Lehnig, Charlotte Schroer, Gerhard Anton Müller, Rolf Wachter, Stephan Lüders, Dieter Zenker, Michael Johann Koziolek
OBJECTIVE: Unlike safety data of baroreflex activation therapy device (Rheos), only few data of the currently used second device (Barostim neo) are available and little is reported about common side effects. METHODS: We prospectively analyzed patients with resistant hypertension treated with Barostim neo. A standardized interview regarding side effects of the therapy was performed in routine follow-up visits after device implantation in 42 patients to determine adverse events staged into three degrees...
April 19, 2018: Journal of Hypertension
https://www.readbyqxmd.com/read/29628351/rationale-and-evidence-for-the-development-of-a-durable-device-based-cardiac-neuromodulation-therapy-for-hypertension
#6
Bing Yang, Yue Wang, Fengxiang Zhang, Weizhu Ju, Hongwu Chen, Yuval Mika, Ricardo Aviv, Steven J Evans, Daniel Burkhoff, Jie Wang, Minglong Chen
We assessed the feasibility of achieving acute, sustained blood pressure reductions through the use of cardiac pacing algorithms delivered via standard dual-chamber pacing based on introducing short atrio-ventricular (AV) delays (SAVD). Eighteen hypertensive subjects (57.3 ± 9.8 years old; 10 male and 8 female) with average initial systolic and diastolic blood pressures of 151.2 ± 17.6/92.2 ± 12.7 mmHg already scheduled to undergo an invasive electrophysiology procedure were included in this study. Pacing sequences were applied for ∼1-minute intervals with AV delays of 80, 40, 20 and 2 ms, while making high fidelity blood pressure measurements...
March 21, 2018: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/29624472/efficacy-and-safety-of-baroreflex-activation-therapy-for-treatment-of-resistant-hypertension-a-systematic-review-and-meta-analysis
#7
Wang Chunbin, Shiquan Fu, Huang Jing
To provide definite evidence for the anti-hypertensive benefit of Baroreflex Activation Therapy (BAT) for resistant hypertension, we performed a systematic review and meta-analysis to evaluate the efficacy and safety of BAT. Electronic searches were conducted in PubMed, EMBASE, The Cochrane Library and Web of Science. Two reviewers independently determined the eligibility of studies and extracted the data. The quality of all included studies was evaluated by the use of the Newcastle Ottawa Scale (NOS). Disagreements were settled through discussion...
April 6, 2018: Clinical and Experimental Hypertension: CHE
https://www.readbyqxmd.com/read/29553350/the-translational-value-of-psychophysiology-methods-and-mechanisms-multilevel-dynamic-personalized
#8
Jennifer F Buckman, Evgeny G Vaschillo, Maria Fonoberova, Igor Mezić, Marsha E Bates
OBJECTIVE: It has been nearly 15 years since Kazdin and Nock published methodological and research recommendations for understanding mechanisms of change in child and adolescent therapy. Their arguments and enthusiasm for research on mechanisms of behavior change (MOBCs) resonated across disciplines and disorders, as it shined a light on the crucial importance of understanding how and for whom treatments instigate behavior change and how therapeutic mechanisms might be extended to "situations and settings of everyday life...
March 2018: Journal of Studies on Alcohol and Drugs
https://www.readbyqxmd.com/read/29443448/an-intraneural-electrode-for-bioelectronic-medicines-for-treatment-of-hypertension
#9
Cristian Sevcencu, Thomas N Nielsen, Johannes J Struijk
OBJECTIVES: As the left vagus nerve (LVN) mediates a baroreflex blood pressure (BP) decrease, LVN stimulation (LVNS) could be a therapy for hypertension. Moreover, LVNS could elegantly be adjusted to the patient's actual BP and physical activity by using the neural information about BP and respiration extractable from LVN. However, unselective LVNS will trigger undesirable side-effects and therefore we here investigated the feasibility of using an intraneural electrode for extracting BP and respiration markers from the LVN and for selective LVNS...
February 14, 2018: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29395374/effects-of-weight-changes-in-the-autonomic-nervous-system-a-systematic-review-and-meta-analysis
#10
João Costa, André Moreira, Pedro Moreira, Luís Delgado, Diana Silva
BACKGROUND: Obesity has been linked to autonomic dysfunction, which is thought to be one of the main contributors for hypertension, cardiac remodelling and death. Exercise and diet-based weight loss are the mainstay therapy for obesity, but there is a paucity of data regarding the effect of weight changes in autonomic nervous system (ANS) activity. OBJECTIVE: To describe the impact of weight changes in autonomic nervous system. METHODS: A systematic literature search of four biomedical databases was performed evaluating effects of weight changes, thorough diet and/or exercise-based interventions, in the following ANS outcomes: heart rate variability, namely low frequency (LF)/high frequency (HF) ratio (LF/HF ratio), normalized units of LF (LFnu) and HF (HFnu), muscle sympathetic nerve activity (MSNA), noradrenaline spillover rate (NA-SR), standard deviation of normal-to-normal intervals (SDNN), root mean square of successive differences (RMSSD), baroreflex sensitivity and pupillometry...
January 9, 2018: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/29316564/primary-prevention-of-stroke-in-chronic-kidney-disease-patients-a-scientific-update
#11
Stefana Catalina Bilha, Alexandru Burlacu, Dimitrie Siriopol, Luminita Voroneanu, Adrian Covic
BACKGROUND: Although chronic kidney disease (CKD) is an independent risk factor for stroke, official recommendations for the primary prevention of stroke in CKD are generally lacking. SUMMARY: We searched PubMed and ISI Web of Science for randomised controlled trials, observational studies, reviews, meta-analyses and guidelines referring to measures of stroke prevention or to the treatment of stroke-associated risk factors (cardiovascular disease in general and atrial fibrillation (AF), arterial hypertension or carotid artery disease in particular) among the CKD population...
2018: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/29297736/increased-receptor-activity-modifying-protein-1-in-the-nervous-system-is-sufficient-to-protect-against-autonomic-dysregulation-and-hypertension
#12
Rasna Sabharwal, Bianca N Mason, Adisa Kuburas, Francois M Abboud, Andrew F Russo, Mark W Chapleau
Calcitonin gene-related peptide (CGRP) can cause migraines, yet it is also a potent vasodilator that protects against hypertension. Given the emerging role of CGRP-targeted antibodies for migraine prevention, an important question is whether the protective actions of CGRP are mediated by vascular or neural CGRP receptors. To address this, we have characterized the cardiovascular phenotype of transgenic nestin/hRAMP1 mice that have selective elevation of a CGRP receptor subunit in the nervous system, human receptor activity-modifying protein 1 (hRAMP1)...
January 1, 2018: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/29136223/baroreceptors-in-the-carotid-and-hypertension-systematic-review-and-meta-analysis-of-the-effects-of-baroreflex-activation-therapy-on-blood-pressure
#13
Manuel Wallbach, Michael J Koziolek
Activation of baroreceptors in the carotid modulates the autonomic nervous system. Baroreflex activation therapy (BAT), which activates baroreceptors in the carotid, has become available in the treatment of resistant hypertension. Besides this, a carotid implant modulating baroreceptors as well as pharmacological modulation of carotid bodies were quite recently presented. This review will underscore currently available and promising approaches that activate baroreceptors in the carotid, and thereby contribute to beneficial effects in patients with arterial hypertension, and discusses potential organoprotective BAT effects beyond blood pressure (BP) reduction...
November 9, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29118300/improvement-of-left-ventricular-ejection-fraction-by-baroreflex-activation-therapy-in-a-young-man-with-dilated-cardiomyopathy
#14
Marcel Halbach, Thorsten Fritz, Navid Madershahian, Roman Pfister, Hannes Reuter
The progression of heart failure with reduced ejection fraction is promoted by sympathovagal imbalance. Baroreflex activation therapy (BAT) by the electrical stimulation of baroreceptors at the carotid sinus significantly improved exercise capacity and NT-proBNP levels in a randomized trial; however, no significant difference in left ventricular ejection fraction (LV-EF) between groups was found. Here, we report the case of a 30-year-old man with a long history of dilated cardiomyopathy and severely reduced LV-EF despite optimal medical therapy, who was treated with BAT since October 2014 and showed a remarkable improvement in both symptoms and LV-EF under this treatment...
November 8, 2017: International Heart Journal
https://www.readbyqxmd.com/read/29118022/tonic-aortic-depressor-nerve-stimulation-does-not-impede-baroreflex-dynamic-characteristics-concomitantly-mediated-by-the-stimulated-nerve
#15
Toru Kawada, Michael J Turner, Shuji Shimizu, Atsunori Kamiya, Toshiaki Shishido, Masaru Sugimachi
Although electrical activation of the carotid sinus baroreflex (baroreflex activation therapy) is being explored as a device therapy for resistant hypertension, possible effects on baroreflex dynamic characteristics of interaction between electrical stimulation and pressure inputs are not fully elucidated. To examine whether the electrical stimulation of the baroreceptor afferent nerve impedes normal short-term arterial pressure (AP) regulation mediated by the stimulated nerve, we electrically stimulated the right aortic depressor nerve (ADN) while estimating the baroreflex dynamic characteristics by imposing pressure inputs to the isolated baroreceptor region of the right ADN in nine anesthetized rats...
March 1, 2018: American Journal of Physiology. Regulatory, Integrative and Comparative Physiology
https://www.readbyqxmd.com/read/29038201/kinin-b1-receptor-promotes-neurogenic-hypertension-through-activation-of-centrally-mediated-mechanisms
#16
Srinivas Sriramula, Eric Lazartigues
Hypertension is associated with increased activity of the kallikrein-kinin system. Kinin B1 receptor (B1R) activation leads to vasoconstriction and inflammation. Despite evidence supporting a role for the B1R in blood pressure regulation, the mechanisms by which B1R could alter autonomic function and participate in the pathogenesis of hypertension remain unidentified. We sought to explore whether B1R-mediated inflammation contributes to hypertension and investigate the molecular mechanisms involved. In this study, we tested the hypothesis that activation of B1R in the brain is involved in the pathogenesis of hypertension, using the deoxycorticosterone acetate-salt model of neurogenic hypertension in wild-type and B1R knockout mice...
December 2017: Hypertension
https://www.readbyqxmd.com/read/29018938/heart-failure-with-preserved-ejection-fraction-current-management-and-future-strategies-expert-opinion-on-the-behalf-of-the-nucleus-of-the-heart-failure-working-group-of-the-german-society-of-cardiology-dkg
#17
REVIEW
Carsten Tschöpe, Christoph Birner, Michael Böhm, Oliver Bruder, Stefan Frantz, Andreas Luchner, Lars Maier, Stefan Störk, Behrouz Kherad, Ulrich Laufs
About 50% of all patients suffering from heart failure (HF) exhibit a reduced ejection fraction (EF ≤ 40%), termed HFrEF. The others may be classified into HF with midrange EF (HFmrEF 40-50%) or preserved ejection fraction (HFpEF, EF ≥ 50%). Presentation and pathophysiology of HFpEF is heterogeneous and its management remains a challenge since evidence of therapeutic benefits on outcome is scarce. Up to now, there are no therapies improving survival in patients with HFpEF. Thus, the treatment targets symptom relief, quality of life and reduction of cardiac decompensations by controlling fluid retention and managing risk factors and comorbidities...
January 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/28955233/hydrogen-sulfide-facilitates-the-impaired-sensitivity-of-carotid-sinus-baroreflex-in-rats-with-vascular-calcification
#18
Hui Li, Xu Teng, Rui Yang, Qi Guo, Hongmei Xue, Lin Xiao, Xiaocui Duan, Danyang Tian, Xiaohong Feng, Yuming Wu
Arterial baroreflex is a general mechanism maintaining cardiovascular homeostasis; its sensitivity is reduced in vascular calcification (VC). Hydrogen sulfide (H2S) treatment facilitates baroreflexive sensitivity in normal and hypertensive rats. Here, we aimed to detect the effect of H2S on baroreflexive sensitivity in rats with VC. The rat VC model was induced by vitamin D3 plus nicotine for 4 weeks. The sensitivity of baroreflex was detected by perfusing the isolated carotid sinus. VC was assessed by hematoxylin and eosin (H&E) staining, Ca(2+) content and alkaline phosphatase (ALP) activity...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28816745/restoration-of-normal-sympathetic-neural-function-in-heart-failure-following-baroreflex-activation-therapy-final-43-month-study-report
#19
Raffaella Dell'Oro, Edoardo Gronda, Gino Seravalle, Giuseppe Costantino, Luca Alberti, Barbara Baronio, Tiziana Staine, Emilio Vanoli, Giuseppe Mancia, Guido Grassi
BACKGROUND: Baroreflex activation therapy (BAT) exerts in severe heart failure sympathoinhibitory effects, improving clinical variables and reducing hospitalization rate. The current follow-up study was aimed at determining the long-term effects of BAT, assessing whether BAT in heart failure allows to restore physiological levels of sympathetic function. METHODS: Seven patients out of the 11 heart failure patients aged 66.5 ± 3 years (mean ± SEM) in New York Heart Association Class III with left ventricular ejection fraction 40% or less and impaired functional capacity recruited in the study survived at the final follow-up (43...
December 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28737621/baroreflex-activation-therapy-a-new-approach-to-the-management-of-advanced-heart-failure-with-reduced-ejection-fraction
#20
Edoardo Gronda, Darrel Francis, Faiez Zannad, Christian Hamm, Josep Brugada, Emilio Vanoli
: Chronic heart failure is a common clinical condition characterized by persistent excessive sympathetic nervous system activation. The derangement of the sympathetic activity has relevant implications for disease progression and patient survival. Aiming to positively impact patient outcome, autonomic nervous system modulatory therapies have been developed and tested in animal and clinical studies. As a general gross assumption, direct vagal stimulation and baroreflex activation are considered equivalent. This assumption does not take into account the fact that direct cervical vagal nerve stimulation involves activation of both afferent and efferent fibers innervating not only the heart, but the entire visceral system, leading to undesired responses to and from this compartment...
September 2017: Journal of Cardiovascular Medicine
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