Renal denervation improved left ventricular ejection fraction by 6.3% compared to control in patients with heart failure with reduced ejection fraction.
Does renal denervation improve clinical and structural outcomes in patients with heart failure?
Renal denervation shows mechanistic promise and potential structural benefits as an adjunct device-based therapy for heart failure, but routine implementation requires validation from rigorous, sham-controlled outcome trials.
Effect estimate: WMD +6.30% (95% CI 4.64%–7.96%)
p-value: p=<0.01
Heart failure (HF) management continues to evolve, yet morbidity and mortality remain high, particularly among patients with comorbid hypertension and heightened sympathetic activity. In this narrative review, we summarize the mechanistic rationale for renal sympathetic denervation (RDN) in HF, synthesize available clinical evidence across HF phenotypes, and highlight key controversies and future research priorities. We emphasize differential responses across geographic regions and consider how ongoing trials may refine patient selection, procedural strategies, and endpoints. As evidence grows, RDN may become an adjunct device-based therapy for selected HF patients, but definitive outcome trials are still needed before routine implementation.
Zhang et al. (Fri,) conducted a review in Patients with heart failure with reduced ejection fraction (HFrEF) (n=352). Renal denervation (RDN) vs. Optimal medical therapy (OMT) or sham control was evaluated on Change in left ventricular ejection fraction (LVEF) (%) (WMD +6.30%, 95% CI 4.64%–7.96%, p=<0.01). Renal denervation improved left ventricular ejection fraction by 6.3% compared to control in patients with heart failure with reduced ejection fraction.