Perspectives of bilateral thoracic sympathectomy for treatment of heart failure
Surgical neuromodulation therapies are still considered a last resort when standard therapies have failed for patients with progressive heart failure (HF). Although a number of experimental studies have provided robust evidence of its effectiveness, the lack of strong clinical evidence discourages p...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Elsevier España
2021-08-01
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| Series: | Clinics |
| Subjects: | |
| Online Access: | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322021000100420&tlng=en |
| _version_ | 1818245223832092672 |
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| author | Raphael dos Santos Coutinho e Silva Fernando Luiz Zanoni Rafael Simas Luiz Felipe Pinho Moreira |
| author_facet | Raphael dos Santos Coutinho e Silva Fernando Luiz Zanoni Rafael Simas Luiz Felipe Pinho Moreira |
| author_sort | Raphael dos Santos Coutinho e Silva |
| collection | DOAJ |
| description | Surgical neuromodulation therapies are still considered a last resort when standard therapies have failed for patients with progressive heart failure (HF). Although a number of experimental studies have provided robust evidence of its effectiveness, the lack of strong clinical evidence discourages practitioners. Thoracic unilateral sympathectomy has been extensively studied and has failed to show significant clinical improvement in HF patients. Most recently, bilateral sympathectomy effect was associated with a high degree of success in HF models, opening the perspective to be investigated in randomized controlled clinical trials. In addition, a series of clinical trials showed that bilateral sympathectomy was associated with a decreased risk of sudden death, which is an important outcome in patients with HF. These aspects indicates that bilateral sympathectomy could be an important alternative in the treatment of HF wherein pharmacological treatment barely reaches the target dose. |
| first_indexed | 2024-12-12T14:29:30Z |
| format | Article |
| id | doaj.art-b218657af33d45debee32fc1ae32bea2 |
| institution | Directory Open Access Journal |
| issn | 1980-5322 |
| language | English |
| last_indexed | 2024-12-12T14:29:30Z |
| publishDate | 2021-08-01 |
| publisher | Elsevier España |
| record_format | Article |
| series | Clinics |
| spelling | doaj.art-b218657af33d45debee32fc1ae32bea22022-12-22T00:21:36ZengElsevier EspañaClinics1980-53222021-08-017610.6061/clinics/2021/e3248Perspectives of bilateral thoracic sympathectomy for treatment of heart failureRaphael dos Santos Coutinho e Silvahttps://orcid.org/0000-0001-8818-5043Fernando Luiz Zanonihttps://orcid.org/0000-0003-4182-6864Rafael Simashttps://orcid.org/0000-0003-4315-1303Luiz Felipe Pinho Moreirahttps://orcid.org/0000-0003-0179-4976Surgical neuromodulation therapies are still considered a last resort when standard therapies have failed for patients with progressive heart failure (HF). Although a number of experimental studies have provided robust evidence of its effectiveness, the lack of strong clinical evidence discourages practitioners. Thoracic unilateral sympathectomy has been extensively studied and has failed to show significant clinical improvement in HF patients. Most recently, bilateral sympathectomy effect was associated with a high degree of success in HF models, opening the perspective to be investigated in randomized controlled clinical trials. In addition, a series of clinical trials showed that bilateral sympathectomy was associated with a decreased risk of sudden death, which is an important outcome in patients with HF. These aspects indicates that bilateral sympathectomy could be an important alternative in the treatment of HF wherein pharmacological treatment barely reaches the target dose.http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322021000100420&tlng=enHeart FailureSympathectomyMyocardial InfarctionDilated CardiomyopathyPulmonary Hypertension |
| spellingShingle | Raphael dos Santos Coutinho e Silva Fernando Luiz Zanoni Rafael Simas Luiz Felipe Pinho Moreira Perspectives of bilateral thoracic sympathectomy for treatment of heart failure Clinics Heart Failure Sympathectomy Myocardial Infarction Dilated Cardiomyopathy Pulmonary Hypertension |
| title | Perspectives of bilateral thoracic sympathectomy for treatment of heart failure |
| title_full | Perspectives of bilateral thoracic sympathectomy for treatment of heart failure |
| title_fullStr | Perspectives of bilateral thoracic sympathectomy for treatment of heart failure |
| title_full_unstemmed | Perspectives of bilateral thoracic sympathectomy for treatment of heart failure |
| title_short | Perspectives of bilateral thoracic sympathectomy for treatment of heart failure |
| title_sort | perspectives of bilateral thoracic sympathectomy for treatment of heart failure |
| topic | Heart Failure Sympathectomy Myocardial Infarction Dilated Cardiomyopathy Pulmonary Hypertension |
| url | http://www.scielo.br/scielo.php?script=sci_arttext&pid=S1807-59322021000100420&tlng=en |
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