Renal sympathetic denervation in patients with vasospastic angina

BACKGROUND: Sympathetic overactivity has been linked to vasospastic angina (VSA), although the exact pathophysiology of VSA is poorly understood. The purpose of this study is to assess if renal sympathetic denervation (RDN) reduces cardiac sympathetic nerve activity with a subsequent beneficial effe...

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Detalles Bibliográficos
Autores principales: Feyz, Lida, Henneman, Maureen, Verzijlbergen, Fred, Kardys, Isabella, Van Mieghem, Nicolas M., Daemen, Joost
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7749092/
https://www.ncbi.nlm.nih.gov/pubmed/30761478
http://dx.doi.org/10.1007/s12350-019-01598-y
Descripción
Sumario:BACKGROUND: Sympathetic overactivity has been linked to vasospastic angina (VSA), although the exact pathophysiology of VSA is poorly understood. The purpose of this study is to assess if renal sympathetic denervation (RDN) reduces cardiac sympathetic nerve activity with a subsequent beneficial effect on angina relief in patients with refractory VSA. METHODS AND RESULTS: Cardiac sympathetic nerve activity was assessed prior to procedure and at 6 months post-procedure using iodine-123 labeled meta-iodobenzylguanidine ((123)I-MIBG) imaging. The Seattle Angina questionnaire (SAQ) was used to assess the degree to which the disease impacts quality of life. No significant change was observed in early HMR (pre-RDN: 2.74 [2.10 to 3.21] vs 6 months post-RDN: 2.57 [2.20 to 3.00]; P = 0.76), and late HMR (pre-RDN: 2.56 [2.18 to 3.20] vs 6 months post-RDN: 2.36 [2.13 to 3.22]; P = 0.22). Additionally, no change was seen in WR (P = 0.22). SAQ results revealed significant improvements in perceived physical limitation, angina frequency, and quality of life at 6 months (P < 0.05 for all). CONCLUSION: RDN resulted in improvements in angina class and quality of life at 6 months in patients with refractory VSA. RDN, however, did not result in significant changes in cardiac sympathetic nerve activity as measured using (123)I-MIBG. The latter observation should be considered with caution given the small sample size of this study. Larger studies are needed to assess this further. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1007/s12350-019-01598-y) contains supplementary material, which is available to authorized users.