Baroreflex activation therapy improves quality of life in patients with HFrEF at 2 years
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Key takeaways:
- Baroreflex activation therapy plus optimal medical therapy improved quality of life at 2 years for patients with HFrEF vs. optimal medical therapy alone.
- Emotional and physical scores were both improved.
Baroreflex activation therapy plus optimal medical therapy improved quality of life at 2 years in patients with HF with reduced ejection fraction compared with optimal medical therapy alone, researchers reported.
The results of a new analysis of the postmarket phase of the BeAT-HF trial of the baroreflex activation therapy system (Barostim, CVRx) in patients with HFrEF were published in JACC: Heart Failure.
The system includes an implanted carotid sinus lead and pulse generator that inhibit the sympathetic nervous system and stimulate the parasympathetic nervous system, according to the study background. As Healio previously reported, in the main results of BeAT-HF, baroreflex activation therapy plus optimal medical therapy reduced N-terminal pro-B-type natriuretic peptide and improved quality of life at 6 months compared with optimal medical therapy in patients with HFrEF and high levels of NT-proBNP.
“The current paper focused on the durability and specificity of perceived patient benefit from Barostim activation therapy,” Samuel F. Sears, PhD, ABPP, professor of psychology and cardiovascular sciences at East Carolina University, assistant director of the ECU Cardiology Fellowship and division chief of innovation and research for the East Carolina Heart Institute, told Healio. “We wanted to know if the quality of life benefits that were demonstrated at 6 months in a previous analysis would hold up at the 2-year point. They were confirmed. Further, we wanted to examine individual symptoms that may have driven that benefit.”
The analysis included 124 patients from the baroreflex activation therapy arm and 105 from the control arm who completed a 2-year visit.
A previous analysis determined that the 2-year change in Minnesota Living with Heart Failure Questionnaire (MLHFQ) overall score favored the baroreflex group (between-group difference, –10; 95% CI, –15.5 to –4.5; P < .001). In the present analysis, the researchers found that the 2-year changes in MLHFQ physical score (between-group difference, –3.7; 95% CI, –6.3 to –1.1) and MLHFQ emotional score (between-group difference, –2; 95% CI, –3.5 to –0.6) also favored the baroreflex group.
The baroreflex group also had better scores on the European Quality of Life–5 Dimensions (EQ-5D) index and overall health status at 2 years compared with the control group, according to the researchers.
“Patients report benefit from [baroreflex activation therapy] in key domains of quality of life such as symptom control, return to key activities and aspects of peace of mind from baseline to the 2-year follow-up,” Sears told Healio. “These findings give information about expectation of benefit in terms of symptom relief and how long they could expect sustained benefit in the context of chronic heart failure. This information can be used in shared decision-making so that patients can consider if the benefits match what they want to achieve. Previous research has indicated that patients are worried about becoming a burden to themselves and their family members due to [congestive] HF. Symptom control/relief and improved functional daily activities remain highly coveted by [congestive] HF patients, and this research suggests [baroreflex activation therapy] may be helpful in achieving those outcomes.”
Reference:
For more information:
Samuel F. Sears, PhD, ABPP, can be reached at searss@ecu.edu.
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