Role of the sympathetic nervous system in cardiometabolic control: implications for targeted multiorgan neuromodulation approaches

Revathy Carnagarin, Marcio G. Kiuchi, Gerard Goh, Leon Adams, Neale Cohen, Helen Kavnoudias, Seng K. Gan, Greg Van Schie, Murray D. Esler, Vance B. Matthews, Markus P. Schlaich

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)

Abstract

Sympathetic overdrive plays a key role in the perturbation of cardiometabolic homeostasis. Diet-induced and exercise-induced weight loss remains a key strategy to combat metabolic disorders, but is often difficult to achieve. Current pharmacological approaches result in variable responses in different patient cohorts and long-term efficacy may be limited by medication intolerance and nonadherence. A clinical need exists for complementary therapies to curb the burden of cardiometabolic diseases. One such approach may include interventional sympathetic neuromodulation of organs relevant to cardiometabolic control. The experience from catheter-based renal denervation studies clearly demonstrates the feasibility, safety and efficacy of such an approach. In analogy, denervation of the common hepatic artery is now feasible in humans and may prove to be similarly useful in modulating sympathetic overdrive directed towards the liver, pancreas and duodenum. Such a targeted multiorgan neuromodulation strategy may beneficially influence multiple aspects of the cardiometabolic disease continuum offering a holistic approach.

Original languageEnglish
Pages (from-to)1478-1489
Number of pages12
JournalJournal of Hypertension
Volume39
Issue number8
DOIs
Publication statusPublished - 1 Aug 2021

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