Percutaneous renal artery denervation in patients with chronic systolic heart failure: A randomized controlled trial

Background: Renal denervation (RDN) is as an effective treatment for heart failure (HF), but its effects on cardiac function of patients with HF are not well documented. Here, the aim was to investigate RDN's effect on patients with chronic systolic HF, by conducting a single-center, prospective, randomized, and controlled study. Methods: Sixty patients with chronic systolic HF were randomly assigned to the RDN or control groups, receiving percutaneous catheter-based RDN with radiofrequency ablation and drug treatment, respectively. All patients performed a 6-minute walk test, echocardiography, blood pressure measurement, and biochemical test, at both baseline and in a 6-month follow up. Results: Over 6-month follow up, patients in RDN group showed a decrease in N-terminal pr B-type natriuretic peptide (440.1 +/- 226.5 pg/mL vs. 790.8 +/- 287.0 pg/mL, p < 0.001, Cohen's d = 1.14), an increase in left ventricular ejection fraction (39.1 +/- 7.3% vs. 35.6 +/- 3.3%, p = 0.017, Cohen's d = 0.61), improved New York Heart Association class assessment (p = 0.01, Cohen's d = 0.66), and decreased blood pressures (p < 0.001, Cohen's d = 0.91), without reporting hypotension and syncope amaurosis. No significant between-group difference was observed for glomerular filtration rate and heart rate. Conclusions: Renal denervation which effectively and safely improves patient's cardiac function as well as exercise tolerance, could be considered as an effective treatment for chronic systolic HF.