Renal Sympathetic Denervation in Patients with Vasospastic Angina

Overview

Journal J Nucl Cardiol

Specialty Cardiology & Vascular Diseases

Date 2019 Feb 15

PMID 30761478

Citations 2

Authors

Lida Feyz

Maureen Henneman

Fred Verzijlbergen

Isabella Kardys

Nicolas M Van Mieghem

Joost Daemen

Affiliations

Soon will be listed here.

Abstract

Background: Sympathetic overactivity has been linked to vasospastic angina (VSA), although the exact pathophysiology of VSA is poorly understood. The purpose of this study is to assess if renal sympathetic denervation (RDN) reduces cardiac sympathetic nerve activity with a subsequent beneficial effect on angina relief in patients with refractory VSA.

Methods And Results: Cardiac sympathetic nerve activity was assessed prior to procedure and at 6 months post-procedure using iodine-123 labeled meta-iodobenzylguanidine (I-MIBG) imaging. The Seattle Angina questionnaire (SAQ) was used to assess the degree to which the disease impacts quality of life. No significant change was observed in early HMR (pre-RDN: 2.74 [2.10 to 3.21] vs 6 months post-RDN: 2.57 [2.20 to 3.00]; P = 0.76), and late HMR (pre-RDN: 2.56 [2.18 to 3.20] vs 6 months post-RDN: 2.36 [2.13 to 3.22]; P = 0.22). Additionally, no change was seen in WR (P = 0.22). SAQ results revealed significant improvements in perceived physical limitation, angina frequency, and quality of life at 6 months (P < 0.05 for all).

Conclusion: RDN resulted in improvements in angina class and quality of life at 6 months in patients with refractory VSA. RDN, however, did not result in significant changes in cardiac sympathetic nerve activity as measured using I-MIBG. The latter observation should be considered with caution given the small sample size of this study. Larger studies are needed to assess this further.

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