Evidence map›Paper›PMID 33714749›Full record

Trial reportJACC. Heart failure2021

Splanchnic Nerve Block Mediated Changes in Stressed Blood Volume in Heart Failure.

Marat Fudim, Manesh R Patel, Richard Boortz-Marx, Barry A Borlaug, Adam D DeVore, Arun Ganesh, Cynthia L Green, Renato D Lopes, Robert J Mentz, Chetan B Patel and 5 more

4 registry-linked trialsOpen access · greenAbstract readClinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in JACC. Heart failure, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 4 registered trials, which are not on this map. Cited by 15 papers.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed
5.2field-weighted citation impact, top 3% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02669407 nacompletednot on this map

Splanchnic Nerve Block for Acute Heart Failure

TypeinterventionalSponsorDuke UniversityRan2017 to 2018Enrolled14ConditionsHeart FailureArmssplanchnic nerve anesthesia with a local anesthetic, regional nerve block with a local anesthetic (Lidocaine)
NCT03453151 phase1 / phase2completednot on this map

Splanchnic Nerve Blockade in Chronic Heart Failure. Splanchnic CHF

TypeinterventionalSponsorDuke UniversityRan2018 to 2019Enrolled19ConditionsHeart FailureArmssplanchnic nerve anesthesia with a local anesthetic
NCT04592445 narecruitingnot on this map

Endovascular Ablation of the Right Greater Splanchnic Nerve in Subjects Having Heart Failure With Preserved Ejection Fraction: Randomized Controlled Feasibility Trial - The Rebalance HF Study

TypeinterventionalSponsorAxon Therapies, Inc.Ran2020 to 2029Enrolled150ConditionsHeart Failure With Preserved Ejection Fraction (HFpEFArmsGreater Splanchnic Nerve Ablation, Sham Control
NCT07403058 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Endovascular Ablation Of The Right Greater Splanchnic Nerve In Subjects Having Heart Failure With Reduced Ejection Fraction: Randomized Controlled Feasibility Trial

TypeinterventionalSponsorAxon Therapies, Inc.Ran2026 to 2028Enrolled50ConditionsHeart Failure With Reduced Ejection Fraction (HFrEF)ArmsRight Greater Splanchnic Nerve (GSN) ablation, Sham Control
3 · Its place in the literature

Who cites it

15 citing papers in PubMed, 38 citations in OpenAlex.

  1. Trial
  2. Article
  3. Review
  4. Left ventricular hemodynamics with veno-arterial extracorporeal membrane oxygenation.Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions · 2024
    Article
  5. Article
  6. Fluid Volume Homeostasis in Heart Failure: A Tale of 2 Circulations.Journal of the American Heart Association · 2022
    Review
  7. Review
  8. Review
  9. Review
  10. Review
  11. Review
  12. Article
  13. Review
  14. Review
  15. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 5 institutions in 2 countries.

Marat FudimDivision of Cardiology, Department of Medicine, Duke University, Durham, North Carolina, USA; Duke Clinical Research Institute, Durham, North Carolina, USA. Electronic address: marat.fudim@duke.edu.
Manesh R PatelDivision of Cardiology, Department of Medicine, Duke University, Durham, North Carolina, USA; Duke Clinical Research Institute, Durham, North Carolina, USA.
Richard Boortz-MarxDivision of Pain Medicine, Department of Anesthesiology, Duke University, Durham, North Carolina, USA.
Barry A BorlaugMayo Clinic, Rochester, Minnesota, USA.
Adam D DeVoreDivision of Cardiology, Department of Medicine, Duke University, Durham, North Carolina, USA; Duke Clinical Research Institute, Durham, North Carolina, USA.
Arun GaneshDivision of Pain Medicine, Department of Anesthesiology, Duke University, Durham, North Carolina, USA.
Cynthia L GreenDuke Clinical Research Institute, Durham, North Carolina, USA; Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina, USA.
Renato D LopesDuke Clinical Research Institute, Durham, North Carolina, USA.
Robert J MentzDivision of Cardiology, Department of Medicine, Duke University, Durham, North Carolina, USA; Duke Clinical Research Institute, Durham, North Carolina, USA.
Chetan B PatelDivision of Cardiology, Department of Medicine, Duke University, Durham, North Carolina, USA.
Joseph G RogersDivision of Cardiology, Department of Medicine, Duke University, Durham, North Carolina, USA; Duke Clinical Research Institute, Durham, North Carolina, USA.
G Michael FelkerDivision of Cardiology, Department of Medicine, Duke University, Durham, North Carolina, USA; Duke Clinical Research Institute, Durham, North Carolina, USA.
Adrian F HernandezDivision of Cardiology, Department of Medicine, Duke University, Durham, North Carolina, USA; Duke Clinical Research Institute, Durham, North Carolina, USA.
Kenji SunagawaCenter for Disruptive Cardiovascular Medicine, Kyushu University, Fukuoka, Japan.
Daniel BurkhoffCardiovascular Research Foundation, New York, New York, USA.
Cardiovascular Research Foundation · USClinical Research Institute · USDuke University · USKyushu University · JPMayo Clinic · US

Funding

MULTIDISCIPLINARY HEART &VASCULAR DISEASEST32HL007101 · NHLBI · DUKE UNIVERSITY · PI FREEDMAN, NEIL J. · 1985 to 2020
$9.8M
HL-Inorganic Nitrite to Enhance Benefits from Exercise Training in Heart Failure with preserved Ejection FractionR01HL128526 · NHLBI · MAYO CLINIC ROCHESTER · PI BORLAUG, BARRY A. · 2016 to 2019
$2.4M
Redefining Pulmonary Hypertension through Pulmonary Vascular Disease Phenomics: Clinical Centers (CC) (U01).U01HL125205 · NHLBI · MAYO CLINIC ROCHESTER · PI FRANTZ, ROBERT PAUL · 2014 to 2018
$1.5M
NHLBI NIH HHS R01 HL128526NHLBI NIH HHS T32 HL007101NHLBI NIH HHS U01 HL125205
6 · The paper itself

Abstract

objectivesThe authors estimated changes of stressed blood volume (SBV) induced by splanchnic nerve block (SNB) in patients with either decompensated or ambulatory heart failure with reduced ejection fraction (HFrEF).

backgroundThe splanchnic vascular capacity is a major determinant of the SBV, which in turn determines cardiac filling pressures and may be modifiable through SNB.

methodsWe analyzed data from 2 prospective, single-arm clinical studies in decompensated HFrEF (splanchnic HF-1; resting hemodynamics) and ambulatory heart failure (splanchnic HF-2; exercise hemodynamics). Patients underwent invasive hemodynamics and short-term SNB with local anesthetics. SBV was simulated using heart rate, cardiac output, central venous pressure, pulmonary capillary wedge pressure, systolic and diastolic systemic arterial and pulmonary artery pressures, and left ventricular ejection fraction. SBV is presented as ml/70 kg body weight.

resultsMean left ventricular ejection fraction was 21 ± 11%. In patients with decompensated HFrEF (n = 11), the mean estimated SBV was 3,073 ± 251 ml/70 kg. At 30 min post-SNB, the estimated SBV decreased by 10% to 2,754 ± 386 ml/70 kg (p = 0.003). In ambulatory HFrEF (n = 14) patients, the mean estimated SBV was 2,664 ± 488 ml/70 kg and increased to 3,243 ± 444 ml/70 kg (p < 0.001) at peak exercise. The resting estimated SBV was lower in ambulatory patients with HFrEF than in decompensated HFrEF (p = 0.019). In ambulatory patients with HFrEF, post-SNB, the resting estimated SBV decreased by 532 ± 264 ml/70 kg (p < 0.001). Post-SNB, with exercise, there was no decrease of estimated SBV out of proportion to baseline effects (p = 0.661).

conclusionsThe estimated SBV is higher in decompensated than in ambulatory heart failure. SNB reduced the estimated SBV in decompensated and ambulatory heart failure. The reduction in estimated SBV was maintained throughout exercise. (Splanchnic Nerve Anesthesia in Heart Failure, NCT02669407; Abdominal Nerve Blockade in Chronic Heart Failure, NCT03453151).

Indexed as

Heart FailureBlood VolumeHumansProspective StudiesSplanchnic NervesStroke VolumeVentricular Function, Leftcongestionheart failuresplanchnic nerve blockstressed blood volumesympathetic nervous system

Identifiers

PMID33714749
PMCPMC9990498
OpenAlexW3134850586

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.