Potential autonomic nervous system effects of statins in heart failure.
Potential autonomic nervous system effects of statins in heart failure.
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DOI：
10.1016/j.hfc.2008.01.004
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发表时间：
2008-04-01
影响因子：
3.4
通讯作者：
Middlekauff, Holly R
中科院分区：
文献类型：
--
作者：
Horwich, Tamara B;Middlekauff, Holly R
心力衰竭中的交感神经系统激活，如由升高的去甲肾上腺素水平、较高的肌肉交感神经活性和降低的心率变异性所指示的，与病理性心室重构、心律失常增加、猝死和死亡率增加相关。最近的证据表明，3-羟基-3-甲基戊二酰辅酶A还原酶抑制剂（他汀类药物）治疗可为缺血性和非缺血性病因的心力衰竭提供生存益处，他汀类药物治疗心力衰竭的一个潜在机制是调节自主神经系统。心力衰竭的动物模型证实了他汀类药物治疗降低了交感神经激活并改善了交感迷走神经平衡。最初的人体研究报告了混合的结果。正在进行的转化研究和结果试验将有助于阐明他汀类药物对心力衰竭自主神经系统的潜在有益作用。
Sympathetic nervous system activation in heart failure, as indexed by elevated norepinephrine levels, higher muscle sympathetic nerve activity and reduced heart rate variability, is associated with pathologic ventricular remodeling, increased arrhythmias, sudden death, and increased mortality. Recent evidence suggests that 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor (statin) therapy may provide survival benefit in heart failure of both ischemic and nonischemic etiology, and one potential mechanism of benefit of statins in heart failure is modulation of the autonomic nervous system. Animal models of heart failure demonstrate reduced sympathetic activation and improved sympathovagal balance with statin therapy. Initial human studies have reported mixed results. Ongoing translational studies and outcomes trials will help delineate the potentially beneficial effects of statins on the autonomic nervous system in heart failure.