4.5 Review Book Chapter

Renal Denervation to Treat Heart Failure

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ANNUAL REVIEW OF PHYSIOLOGY, VOL 83
卷 83, 期 -, 页码 39-58

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ANNUAL REVIEWS
DOI: 10.1146/annurev-physiol-031620-093431

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sympathetic nerve system; heart failure; cardiorenal syndrome; renal denervation; heart failure with preserved ejection fraction

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Heart failure is a global pandemic with challenges in treatment, particularly in patient tolerance to neurohormonal pharmacotherapies. Renal denervation as a novel therapeutic strategy provides a potential possibility to attenuate the progression of HF.
Heart failure (HF) is a global pandemic with a poor prognosis after hospitalization. Despite HF syndrome complexities, evidence of significant sympathetic overactivity in the manifestation and progression of HF is universally accepted. Confirmation of this dogma is observed in guideline-directed use of neurohormonal pharmacotherapies as a standard of care in HF. Despite reductions in morbidity and mortality, a growing patient population is resistant to these medications, while off-target side effects lead to dismal patient adherence to lifelong drug regimens. Novel therapeutic strategies, devoid of these limitations, are necessary to attenuate the progression of HF pathophysiology while continuing to reduce morbidity and mortality. Renal denervation is an endovascular procedure, whereby the ablation of renal nerves results in reduced renal afferent and efferent sympathetic nerve activity in the kidney and globally. In this review, we discuss the current state of preclinical and clinical research related to renal sympathetic denervation to treat HF.

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