Wang Dong, Mueller-Leisse Johanna, Hillmann Henrike A K, Eiringhaus Jörg, Berliner Dominik, Karfoul Nizar, Schmitto Jan D, Ruhparwar Arjang, Bauersachs Johann, Duncker David
Department of Cardiology and Angiology, Hannover Medical School, Hanover, Germany.
Department of Cardiothoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hanover, Germany.
ESC Heart Fail. 2025 Feb;12(1):166-173. doi: 10.1002/ehf2.15104. Epub 2024 Oct 8.
Baroreceptor activation therapy (BAT) is a promising new treatment strategy for patients with heart failure with reduced ejection fraction (HFrEF). It provides symptomatic relief, improvement in left ventricular function and reduction of cardiac biomarkers. Data regarding the long-term effect of BAT on HFrEF are scarce. This retrospective, monocentric study aimed to assess long-term outcome in patients who underwent BAT.
Patients with HFrEF who received BAT at Hannover Medical School between 2014 and 2023 were followed until the latest available follow-up. Symptom burden, echocardiography and laboratory testing were assessed before BAT implantation and in subsequent follow-ups.
Twenty-three patients (mean age 66 ± 10 years, 83% male) with HFrEF were included in the study. Aetiology of heart failure was ischaemic in 70%. The majority of patients (96%) suffered from New York Heart Association (NYHA) III with a mean left ventricular ejection fraction (LVEF) of 23 ± 8% and N-terminal pro-B-type natriuretic peptide (NT-proBNP) of 2463 ± 2922 pg/mL. A complication occurred in one patient during BAT implantation (4%). The mean follow-up was 3 ± 2 (max. 7.5) years. BAT reduced NYHA classification in 12 patients (52%) after 1 year, of which one patient remained in ameliorated NYHA for 7.5 years. Echocardiographic evaluation revealed significant improvement in LVEF by 9 ± 9% after 1 year (P < 0.001) and by 11 ± 9% (P = 0.005) after 2 years. In addition, BAT mildly reduced NT-proBNP in the first 2 years [non-significantly after 1 year by 396 ± 1006 pg/mL and significantly after 2 years by 566 ± 651 pg/mL (P = 0.039)]. Seven patients reaching the recommended replacement time underwent device exchange. Four patients died during observation time.
BAT resulted in a substantial reduction in NYHA classification and improvement in LVEF that lasted over long-term follow-up in many patients. NT-proBNP level decreased interim in long-term follow-up. These findings highlight the long-term efficacy and potential benefits of BAT as a therapeutic intervention for patients with HFrEF.
压力感受器激活疗法（BAT）是一种针对射血分数降低的心力衰竭（HFrEF）患者的有前景的新治疗策略。它能缓解症状、改善左心室功能并降低心脏生物标志物水平。关于BAT对HFrEF长期影响的数据很少。这项回顾性、单中心研究旨在评估接受BAT治疗患者的长期结局。
对2014年至2023年在汉诺威医学院接受BAT治疗的HFrEF患者进行随访，直至最新的可用随访时间。在BAT植入前及随后的随访中评估症状负担、超声心动图和实验室检查。
23例HFrEF患者（平均年龄66±10岁，83%为男性）纳入研究。70%的心力衰竭病因是缺血性的。大多数患者（96%）为纽约心脏协会（NYHA）Ⅲ级，平均左心室射血分数（LVEF）为23±8%，N末端B型脑钠肽原（NT-proBNP）为2463±2922 pg/mL。1例患者在BAT植入期间出现并发症（4%）。平均随访时间为3±2（最长7.5）年。1年后，BAT使12例患者（52%）的NYHA分级降低，其中1例患者NYHA改善状态持续了7.5年。超声心动图评估显示，1年后LVEF显著改善9±9%（P<0.001），2年后改善11±9%（P=0.005）。此外，BAT在最初2年内使NT-proBNP轻度降低[1年后非显著降低396±1006 pg/mL，2年后显著降低566±651 pg/mL（P=0.039）]。7例达到推荐更换时间的患者进行了设备更换。4例患者在观察期内死亡。
BAT使NYHA分级大幅降低，LVEF改善，且在许多患者的长期随访中持续存在。长期随访中NT-proBNP水平中期下降。这些发现突出了BAT作为HFrEF患者治疗干预措施的长期疗效和潜在益处。
