Autonomic Modulation for Cardiovascular Disease.

Autonomic Modulation for Cardiovascular Disease.
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心血管疾病的自主调节。

DOI:
10.3389/fphys.2020.617459
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发表时间:
2020
影响因子:
4
通讯作者:
Ardell JL
Ardell JL
中科院分区:
医学2区
文献类型:
--
作者:
Hadaya J;Ardell JL

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自主神经系统的功能障碍与心血管疾病的发病机制有关,包括充血性心力衰竭和心律失常。尽管这些实体的医疗和手术管理取得了进展,但疾病进展仍然存在,心脏性猝死的风险也存在。随着对神经系统和心脏之间的动态关系的认识的提高,神经调节技术如心脏交感神经去支配和迷走神经刺激(VNS)已经成为用于管理这些疾病的可能的治疗方法。在这篇综述中,我们介绍了心脏神经系统的结构和功能以及疾病状态下发生的重塑,强调了交感神经兴奋增加和副交感神经张力降低的概念。我们回顾迷走神经刺激的临床前证据,以及充血性心力衰竭临床试验的早期结果。迷走神经刺激和其他神经调节技术,可能会改善心血管疾病的管理,并值得进一步研究。
Dysfunction of the autonomic nervous system has been implicated in the pathogenesis of cardiovascular disease, including congestive heart failure and cardiac arrhythmias. Despite advances in the medical and surgical management of these entities, progression of disease persists as does the risk for sudden cardiac death. With improved knowledge of the dynamic relationships between the nervous system and heart, neuromodulatory techniques such as cardiac sympathetic denervation and vagal nerve stimulation (VNS) have emerged as possible therapeutic approaches for the management of these disorders. In this review, we present the structure and function of the cardiac nervous system and the remodeling that occurs in disease states, emphasizing the concept of increased sympathoexcitation and reduced parasympathetic tone. We review preclinical evidence for vagal nerve stimulation, and early results of clinical trials in the setting of congestive heart failure. Vagal nerve stimulation, and other neuromodulatory techniques, may improve the management of cardiovascular disorders, and warrant further study.
DOI: 10.1161/circulationaha.104.525493
发表时间: 2005-07-12
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影响因子: 37.8
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