Splanchnic Nerve Block for Acute Heart Failure

The abdominal vascular compartment is the main storage of intravascular blood volume, and decreased abdominal vascular capacitance has been proposed as a major contributor to the complex pathophysiology of heart failure (HF) in animals and humans. 1, 2 In HF, as a result of neurohormonal imbalance, the vascular capacitance ("storage-space") is decreased and acute sympathetic nerve activation can result in acute volume redistribution 3 from the abdominal compartment to the thoracic compartment (heart and lungs), which increases intra-cardiac pressures and precipitates HF symptoms (Figure 1A). The sympathetic nervous system controls the splanchnic compartment via branches from the sympathetic thoracic ganglia (T6 through T11). 4 We have identified the splanchnic nerves as a potential target for treating HF.