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Current Vascular Pharmacology

Eiditor-in-Chief

ISSN (Print): 1570-1611
ISSN (Online): 1875-6212

Review Article

Non-pharmacological Modulation of the Autonomic Nervous System for Heart Failure Treatment: Where do We Stand?

Author(s): Costas Tsioufis*, Panayiotis Iliakis, Alexandros Kasiakogias, Dimitrios Konstantinidis, Dragan Lovic, Dimitrios Petras, Michalis Doumas, Eleftherios Tsiamis, Vasilios Papademetriou and Dimitrios Tousoulis

Volume 16 , Issue 1 , 2018

Page: [30 - 43] Pages: 14

DOI: 10.2174/1570161115666170428124756

Price: $58

Abstract

Introduction: An imbalance in the Autonomic Nervous System (ANS) is a central pathophysiologic mechanism in Heart Failure (HF) and has been a principal target of treatment in these patients. Traditional pharmacologic agents do not provide specific modulation of discrete arms of the ANS, while side effects may lead to poor tolerance. Technological advances have provided a series of invasive methods that may provide a focused effect on the ANS in selected patient groups. Renal denervation, initially targeted for patients with resistant hypertension, has given positive preliminary results in terms of heart structure and function. Baroreceptor stimulation also has ongoing research with respect to its efficacy and longer term effects in HF patients. Vagal nerve stimulation and spinal cord stimulation have limited data but represent novel treatments that target the hard to reach parasympathetic system.

Conclusion: The present review overviews the pathophysiologic basis, current preclinical and clinical data and future expectations of these promising treatments.

Keywords: Sympathetic nervous system, neuromodulation, renal denervation, baroreceptor stimulation, vagal nerve stimulation, spinal cord stimulation.

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