Heart Failure -> Heart Failure Management: -> Clinical Trials D-MP02 - Newer technologies in managing and predicting outcomes in HF and AF patients (ID 50) Moderated ePoster

D-MP02-02 - Drugs, Baroreflex Activation Therapy And Outcome: Do Patients Benefit From On Top Baroreflex Activation Therapy? (ID 2)

Disclosure
 D. Guckel: Nothing relevant to disclose.

Abstract

Background: Baroreflex Activation Therapy (BAT) is a new treatment option for patients (pts) suffering from advanced heart failure (HF) with reduced left ventricular ejection fraction (HFrEF). Data on the outcome of additional BAT is scarce.
Objective: Our aim was to evaluate the outcome of BAT pts in comparison to HFrEF pts solely treated with a guideline directed medical therapy (GDMT) in particular regarding effects of Sacubitril/Valsartan (ARNI) on the BAT response.
Methods: In this single center prospective study 40 HFrEF pts (67 ± 1.8 years) eligible for BAT (EF 27 ± 1%, NYHA class III, NT-proBNP 2302 ± 460pg/mL, 6-minute hall walk distances (6MHWD) 281 ± 23m) were included. 10 of these pts were implanted with a BAT device. Follow-up visits (FU) were performed after 3, 6 and 12 months. Primary efficacy endpoints included an improvement in quality of life (EQ-5D-5L), NYHA class, left ventricular ejection fraction (LVEF), HF hospitalization rate, NT-proBNP levels and 6MHWD.
Results: BAT as well as BAT+ARNI treated pts showed a significant increase in LVEF (BATLVEF BL 23 ± 2%to 12mFU 33 ± 2%, + 10%, p-value=0.01; BAT+ARNILVEF BL 23 ± 1%to 12mFU 32 ± 2%, + 9%, p-value=0.05). No changes could be observed in the control group (noBATLVEF BL29 ± 1%to 12mFU 31 ± 1%, + 3%, p-value =0.09). BAT pts presented with a significant improvement in NYHA class (BATNYHA class III BL 10 pts (100%) to 12mFU 2 pts (20%), - 80%, p-value=0.01) as well as a significant increase in QoL points (BATQoL BL44 ± 6 to 12mFU 65 ± 5, + 21%, p-value =0.02). Control group pts showed no changes but developed a significant increase in NT-proBNP levels (noBATNT-proBNP BL 2044 ± 359pg/mLto 12mFU 2749 ± 756pg/mL, + 35%, p-value =0.04) in comparison to BAT pts (BATNT-proBNP BL 2532 ± 258pg/mLto 12mFU 2999 ± 819pg/mL, + 18%, p-value=0.83). BAT+ARNI treated pts presented with reduced NT-proBNP levels (BAT + ARNINT-proBNP BL 3043 ± 339pg/mL to 12mFU 1922 ± 342pg/mL, - 37%, p-value =0.49). HF hospitalization rates of BAT pts (50%) were significantly lower compared to control group pts (83 %) (p-value=0.02).
Conclusion: BAT as well as BAT+ARNI improves outcome with regard to LVEF, NYHA class, QoL and NT-proBNP levels. Concerning these results BAT seems to be a helpful and promising therapeutic tool in the treatment of pts with HFrEF.
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