PMID- 23099357
OWN - NLM
STAT- MEDLINE
DCOM- 20130527
LR  - 20121128
IS  - 1879-0844 (Electronic)
IS  - 1388-9842 (Linking)
VI  - 14
IP  - 12
DP  - 2012 Dec
TI  - Left cardiac sympathetic denervation for treatment of symptomatic systolic heart 
      failure patients: a pilot study.
PG  - 1366-73
LID - 10.1093/eurjhf/hfs132 [doi]
AB  - AIMS: To evaluate the feasibility, safety, and potential beneficial effects of 
      left cardiac sympathetic denervation (LCSD) in systolic heart failure (HF) 
      patients. METHODS AND RESULTS: In this prospective, randomized pilot study, 
      inclusion criteria were New York Heart Association (NYHA) functional class II or 
      III, left ventricular ejection fraction (LVEF) </=40%, sinus rhythm, and resting 
      heart rate >65 b.p.m., despite optimal medical therapy (MT). Fifteen patients 
      were randomly assigned either to MT alone or MT plus LCSD. The primary endpoint 
      was safety, measured by mortality in the first month of follow-up and morbidity 
      according to pre-specified criteria. Secondary endpoints were exercise capacity, 
      quality of life, LVEF, muscle sympathetic nerve activity (MSNA), brain 
      natriuretic peptide (BNP) levels and 24 h Holter mean heart rate before and after 
      6 months. We studied clinical effects in long-term follow-up. Ten patients 
      underwent LCSD. There were no adverse events attributable to surgery. In the LCSD 
      group, LVEF improved from 25 +/- 6.6 to 33 +/- 5.2 (P = 0.03); 6 min walking distance 
      improved from 167 +/- 35 to 198 +/- 47 m (P = 0.02). Minnesota Living with Heart 
      Failure Questionnaire (MLWHFQ) score physical dimension changed from 21 +/- 5 to 15 
      +/- 7 (P = 0.06). The remaining analysed variables were unchanged. During 848 +/- 549 
      days of follow-up, in the MT group, three patients either died or underwent 
      cardiac transplantation (CT), while in the LCSD group six were alive without CT. 
      CONCLUSIONS: LCSD was feasible and seemed to be safe in systolic HF patients. Its 
      beneficial effects warrant the development of a larger randomized trial. Trail 
      registration: NCT01224899.
FAU - Conceicao-Souza, Germano Emilio
AU  - Conceicao-Souza GE
AD  - Heart Institute Hospital das Clinicas da Faculdade de Medicina da Universidade de 
      Sao Paulo, Sao Paulo, Brazil.
FAU - Pego-Fernandes, Paulo Manuel
AU  - Pego-Fernandes PM
FAU - Cruz, Fatima das Dores
AU  - Cruz Fd
FAU - Guimaraes, Guilherme Veiga
AU  - Guimaraes GV
FAU - Bacal, Fernando
AU  - Bacal F
FAU - Vieira, Marcelo Luiz Campos
AU  - Vieira ML
FAU - Grupi, Cesar Jose
AU  - Grupi CJ
FAU - Giorgi, Maria Clementina Pinto
AU  - Giorgi MC
FAU - Consolim-Colombo, Fernanda Marciano
AU  - Consolim-Colombo FM
FAU - Negrao, Carlos Eduardo
AU  - Negrao CE
FAU - Rondon, Maria Urbana P
AU  - Rondon MU
FAU - Moreira, Luiz Felipe Pinho
AU  - Moreira LF
FAU - Bocchi, Edimar Alcides
AU  - Bocchi EA
LA  - eng
SI  - ClinicalTrials.gov/NCT01224899
PT  - Journal Article
PT  - Randomized Controlled Trial
PT  - Research Support, Non-U.S. Gov't
DEP - 20121025
PL  - England
TA  - Eur J Heart Fail
JT  - European journal of heart failure
JID - 100887595
SB  - IM
CIN - Eur J Heart Fail. 2012 Dec;14(12):1316-8. PMID: 23129479
MH  - Adult
MH  - Aged
MH  - Endpoint Determination
MH  - Female
MH  - Heart Failure, Systolic/mortality/*physiopathology/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Physical Endurance/physiology
MH  - Pilot Projects
MH  - Prospective Studies
MH  - Quality of Life
MH  - Survival Rate
MH  - Sympathectomy/*methods
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/physiopathology
EDAT- 2012/10/27 06:00
MHDA- 2013/05/29 06:00
CRDT- 2012/10/27 06:00
PHST- 2012/10/27 06:00 [entrez]
PHST- 2012/10/27 06:00 [pubmed]
PHST- 2013/05/29 06:00 [medline]
AID - hfs132 [pii]
AID - 10.1093/eurjhf/hfs132 [doi]
PST - ppublish
SO  - Eur J Heart Fail. 2012 Dec;14(12):1366-73. doi: 10.1093/eurjhf/hfs132. Epub 2012 
      Oct 25.