Autonomic Regulation Therapy for the Improvement of Left Ventricular Function and Heart Failure Symptoms: The ANTHEM-HF Study

DiCarlo, Lorenzo A.; Libbus, Imad; Amurthur, Badri; KenKnight, Bruce H.; Anand, Inder S.

doi:10.1016/j.cardfail.2013.07.002

Cited by 62 publications

(56 citation statements)

References 24 publications

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“…166 The Autonomic Neural Regulation Therapy to Enhance Myocardial Function in Heart Failure (ANTHEM-HF) study will use the Cyberonics vagal nerve stimulation therapy system to provide additional information on the role of autonomic regulation therapy in patients with LV dysfunction and chronic symptomatic HF. 167 …”

Section: Vagal Nerve Stimulationmentioning

confidence: 99%

The Autonomic Nervous System and Heart Failure

Florea

Cohn

2014

Circulation Research

439

366

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Abstract:The pathophysiology of heart failure (HF) is characterized by hemodynamic abnormalities that result in neurohormonal activation and autonomic imbalance with increase in sympathetic activity and withdrawal of vagal activity. Alterations in receptor activation from this autonomic imbalance may have profound effects on cardiac function and structure. Inhibition of the sympathetic drive to the heart through β-receptor blockade has become a standard component of therapy for HF with a dilated left ventricle because of its effectiveness in inhibiting the ventricular structural remodeling process and in prolonging life. Several devices for selective modulation of sympathetic and vagal activity have recently been developed in an attempt to alter the natural history of HF. The optimal counteraction of the excessive sympathetic activity is still unclear. A profound decrease in adrenergic support with excessive blockade of the sympathetic nervous system may result in adverse outcomes in clinical HF. In this review, we analyze the data supporting a contributory role of the autonomic functional alterations on the course of HF, the techniques used to assess autonomic nervous system activity, the evidence for clinical effectiveness of pharmacological and device interventions, and the potential future role of autonomic nervous system modifiers in the management of this syndrome. (Circ Res. 2014;114:1815-1826.) Key Words: autonomic nervous system ■ heart failure ■ norepinephrine ■ receptors, adrenergicThe Autonomic Nervous System and Heart Failure Viorel G. Florea, Jay N. Cohn This Review is in a thematic series on The Autonomic Nervous System and the Cardiovascular System, which includes the following articles: Role of the Autonomic Nervous System in Modulating Cardiac Arrhythmias [Circ Res. 2014;114:1004-1021 The Autonomic Nervous System and Hypertension [Circ Res. 2014;114:1804-1814 The Autonomic Nervous System and Heart Failure Renal Denervation for the Treatment of Cardiovascular High Risk-Hypertension or Beyond? Original received February 10, 2014; revision received April 29, 2014; accepted April 29, 2014. In March 2014, the average time from submission to first decision for all original research papers submitted to Circulation Research was 12.63 days.From the Minneapolis VA Health Care System, Section of Cardiology (V.G.F.) and Rasmussen Center for Cardiovascular Disease Prevention, Department of Medicine (J.N.C.), University of Minnesota Medical School.Correspondence to Jay N. endocardium. Parasympathetic effects are carried by the right and left vagus nerves, originating in the medulla. The vagus nerve further divides into the superior and inferior cardiac nerves, finally merging with the postganglionic sympathetic neurons to form a plexus of nerves at the base of the heart, known as the cardiac plexus. 1The 2 mediators of the SNS, norepinephrine and epinephrine, derive from 2 major sources in the body: the sympathetic nerve endings, which release norepinephrine directly into the synaptic cleft, and the adren...

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Section: Vagal Nerve Stimulationmentioning

confidence: 99%

The Autonomic Nervous System and Heart Failure

Florea

Cohn

2014

Circulation Research

439

366

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“…ANTHEM-HF should provide additional and valuable information regarding the safety and the relationship between the site and intensity of ART and its salutary effects on HF in patients with overall poor prognosis despite being on neurohormonal blocking agents and CRT [47].…”

Section: Vagus Nerve Stimulation and Role Of Autonomic Regulation In mentioning

confidence: 99%

Recent Advances in the Optimization of Cardiac Resynchronization Therapy

Chandraprakasam

Mentzer

2014

Curr Heart Fail Rep

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Heart failure (HF) continues to grow and affect more than five million people in the USA. One of the leading device therapies in HF is cardiac resynchronization therapy (CRT) which has been studied for over 20 years. Recent advancements in lead placement, lead technology, patient selection, and CRT optimization by electrical maneuvers and imaging modalities have improved outcomes in morbidity, hospitalization reductions and mortalities in those who have responded CRT therapy. This review article is intended to discuss the mechanisms and benefits of CRT, clinical trials, and guidelines for CRT along with a focus on recent updates from the past 3 to 5 years and glimpse into future directions.

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“…This was followed by a feasibility study, the Autonomic Neural Regulation Therapy to Enhance Myocardial Function in Heart Failure (ANTHEM-HF) study [ 15 ], which used the Cyberonics vagal nerve stimulation therapy system and provides additional information on the role of autonomic regulation therapy in patients with LV dysfunction and chronic symptomatic HF. In this study, subjects were randomized to thoracic subcutaneous vagal nerve stimulation (VNS) therapy system implantation for either right or left cervical VNS.…”

Section: Vagal Nerve Stimulationmentioning

confidence: 99%

Heart Failure, Introduction

Shah

Palaskas

Bozkurt

2015

Pathophysiology and Pharmacotherapy of Cardiovascular Disease

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Heart failure (HF) is a growing worldwide epidemic that results in signifi cant morbidity and mortality in the aging population. HF is an important contributor to both the burden and cost of national healthcare expenditures, with more older Americans hospitalized for HF than for any other medical condition. Over the last two decades, there has been considerable progress in the treatment of HF with angiotensin-converting-enzyme (ACE) inhibitors, aldosterone antagonists, beta-receptor blockers, and resynchronization therapy. Nevertheless, HF is still associated with a poor prognosis. Approximately half of the people who develop HF die within 5 years of diagnosis. The search for better treatments for HF is one of the major challenges in cardiology. Greater understanding of the molecular dynamics and humoral perturbation will lead to newer HF treatment. In this chapter, different etiologies of HF, a systematic approach to the evaluation of a patient with HF, current strategies for the treatment, and emerging therapies in this fi eld are discussed.

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Autonomic Regulation Therapy for the Improvement of Left Ventricular Function and Heart Failure Symptoms: The ANTHEM-HF Study

Abstract: ANTHEM-HF should provide additional and valuable information regarding the safety and the relationship between the site and intensity of ART and its salutary effects on HF.

Cited by 62 publications

References 24 publications

The Autonomic Nervous System and Heart Failure

The Autonomic Nervous System and Heart Failure

Recent Advances in the Optimization of Cardiac Resynchronization Therapy

Heart Failure, Introduction

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