{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:51:07Z","timestamp":1773967867118,"version":"3.50.1"},"reference-count":33,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"14","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2023,7,18]]},"abstract":"<jats:sec sec-type=\"background\" xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Splanchnic nerve modulation (SNM) is an emerging procedure to reduce cardiac filling pressures in heart failure. Although the main contributor to reduction in cardiac preload is thought to be increased venous capacitance in the splanchnic circulation, supporting evidence is limited. We examined changes in venous capacitance surrogates pre\u2010 and post\u2010SNM.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              This is a prespecified analysis of a prospective, open\u2010label, single\u2010arm interventional study evaluating the effects of percutaneous SNM with ropivacaine in chronic heart failure with elevated filling pressures at rest and with exercise. Patients underwent cardiopulmonary exercise testing with invasive hemodynamic assessment pre\u2010 and post\u2010SNM. Blood pressure changes with modified Valsalva maneuver and hemoconcentration, pre\u2010 and post\u2010SNM were compared using a repeated measures model. Inferior vena cava diameter and collapsibility (&gt;50% decrease in size with inspiration), and presence of bendopnea pre\u2010 and post\u2010SNM were also compared. Fifteen patients undergoing SNM (age 58\u2009years, 47% women, 93% with left ventricular ejection fraction \u226435%) were included. After SNM, changes in systolic blood pressure during Valsalva (peak\u2010to\u2010trough) were greater (41 versus 48\u2009mm\u2009Hg,\n              <jats:italic>P<\/jats:italic>\n              =0.025). Exercise\u2010induced hemoconcentration was unchanged (0.63 versus 0.43\u2009g\/dL,\n              <jats:italic>P<\/jats:italic>\n              =0.115). Inferior vena cava diameter was reduced (1.59 versus 1.30\u2009cm,\n              <jats:italic>P<\/jats:italic>\n              =0.034) with higher collapsibility (33% versus 73%,\n              <jats:italic>P<\/jats:italic>\n              =0.014). Bendopnea was less (47% versus 13%,\n              <jats:italic>P<\/jats:italic>\n              =0.025).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">SNM resulted in increased venous capacitance, associated decreased cardiac preload, and decreased bendopnea. Minimally invasive measures of venous capacitance could serve as markers of successful SNM. Long\u2010term effects of SNM on venous capacitance warrant further investigation for heart failure management.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicaltrials.gov\">https:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              ; Unique identifier: NCT03453151.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.122.028780","type":"journal-article","created":{"date-parts":[[2023,7,14]],"date-time":"2023-07-14T11:01:21Z","timestamp":1689332481000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":4,"title":["Splanchnic Nerve Modulation Effects on Surrogate Measures of Venous Capacitance"],"prefix":"10.1161","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9107-1837","authenticated-orcid":false,"given":"Veraprapas","family":"Kittipibul","sequence":"first","affiliation":[{"name":"Division of Cardiology, Department of Medicine Duke University Durham NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arun","family":"Ganesh","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Duke University Medical Center Durham NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aubrie","family":"Coburn","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Duke University Durham NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9305-6473","authenticated-orcid":false,"given":"Brian J.","family":"Coyne","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Duke University Durham NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6857-9934","authenticated-orcid":false,"given":"James Matthew","family":"Gray","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Duke University Durham NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0608-3305","authenticated-orcid":false,"given":"Jeroen","family":"Molinger","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Duke University Durham NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Neil","family":"Ray","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Duke University Medical Center Durham NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5539-4674","authenticated-orcid":false,"given":"Mihai","family":"Podgoreanu","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Duke University Medical Center Durham NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon L.","family":"McCartney","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Duke University Medical Center Durham NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4022-487X","authenticated-orcid":false,"given":"Negmeldeen","family":"Mamoun","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology Duke University Medical Center Durham NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Robert Curtis","family":"Fitzhugh","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine Duke 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