Device Therapy to Modulate the Autonomic Nervous System to Treat Heart Failure
Device Therapy to Modulate the Autonomic Nervous System to Treat Heart Failure
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DOI：
10.1007/s11886-012-0292-8
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发表时间：
2012-10-01
影响因子：
3.7
通讯作者：
Zipes, Douglas P.
中科院分区：
文献类型：
--
作者：
Lopshire, John C.;Zipes, Douglas P.
心力衰竭是许多形式的心脏病的最终共同途径，并且与过度的发病率和死亡率相关。在晚期心力衰竭中，心脏和自主神经系统之间相互作用的病理生理学改变已经被注意了几十年。在过去的十年中，心力衰竭的内科和外科治疗取得了巨大进展-其中一些方法针对神经-心脏轴。尽管取得了这些进展，但许多患者进展为终末期心力衰竭和死亡。最近，以神经-心脏轴为靶点的基于装置的治疗与各种形式的神经调节刺激已被证明可以改善实验性心力衰竭模型的心脏功能。这些包括脊髓刺激、迷走神经刺激和压力反射调制。目前正在进行人体试验，以评估这些基于设备的神经调节方式在心力衰竭人群中的安全性和有效性。
Heart failure is the final common pathway in many forms of heart disease, and is associated with excessive morbidity and mortality. Pathophysiologic alterations in the interaction between the heart and the autonomic nervous system in advanced heart failure have been noted for decades. Over the last decade, great advances have been made in the medical and surgical treatment of heart failure - and some of these modalities target the neuro-cardiac axis. Despite these advances, many patients progress to end-stage heart failure and death. Recently, device-based therapy targeting the neuro-cardiac axis with various forms of neuromodulatory stimuli has been shown to improve heart function in experimental heart failure models. These include spinal cord stimulation, vagal nerve stimulation, and baroreflex modulation. Human trials are now underway to evaluate the safety and efficacy of these device-based neuromodulatory modalities in the heart failure population.