Abstract:
Neuromodulation therapy, like spinal cord stimulation (SCS), benefits individuals with chronic diseases, improving outcomes of patients with heart failure (HF). This systematic review aims to investigate the efficacy of SCS when used as an adjunctive therapy in HF. A systematic analysis of all studies that included SCS therapy in human participants with HF was conducted. After excluding studies not meeting specific criteria, 4 studies involving a total of 125 participants were selected. All participants had heart failure with the New York Heart Association (NYHA) classification ranging from 2.2 ± 0.4 to 3. The primary endpoints for assessment included the impact of SCS in HF-related symptoms, Left ventricular function, VO2 max, and NT-proBNP. All the studies could demonstrate safety and feasibility of SCS therapy, although the outcomes varied. Two studies reported improvement in NYHA classification, MLHFQ and QoL parameters after SCS. Concerning LVEF and VO2 max, only one study indicated positive changes. None of the studies found a significant change of NT-proBNP following SCS therapy. Given methodological variation, discrepancies in the results could be attributed to the diversity of the induction technique. Further studies are needed to develop a solid approach for employing SCS in human patients with HF.
摘要:
神经调节疗法,像脊髓刺激(SCS),使患有慢性病的人受益,改善心力衰竭(HF)患者的预后。本系统评价旨在探讨SCS作为HF辅助治疗的疗效。对所有包括SCS治疗的HF患者的研究进行了系统分析。排除不符合特定标准的研究后,4项研究共纳入125名参与者。所有参与者均患有心力衰竭,纽约心脏协会(NYHA)分类范围为2.2±0.4至3。评估的主要终点包括SCS对HF相关症状的影响,左心室功能,VO2最大值,和NT-proBNP。所有研究都可以证明SCS治疗的安全性和可行性,尽管结果各不相同。两项研究报告NYHA分类有所改善,SCS后的MLHFQ和QoL参数。关于LVEF和VO2最大值,只有一项研究显示了积极的变化.没有一项研究发现SCS治疗后NT-proBNP的显著变化。鉴于方法上的差异,结果的差异可归因于诱导技术的多样性。需要进一步的研究来开发在人类HF患者中使用SCS的可靠方法。