Abstract:
Increased sympathetic and reduced parasympathetic nerve activity is associated with disease progression and poor outcomes in patients with chronic heart failure. The demonstration that markers of autonomic imbalance and vagal dysfunction, such as reduced heart rate variability and baroreflex sensitivity, hold prognostic value in patients with chronic heart failure despite modern therapies encourages the research for neuromodulation strategies targeting the vagus nerve. However, the approaches tested so far have yielded inconclusive results. This review aims to summarize the current knowledge about the role of the parasympathetic nervous system in chronic heart failure, describing the pathophysiological background, the methods of assessment, and the rationale, limits, and future perspectives of parasympathetic stimulation either by drugs or bioelectronic devices.
摘要:
交感神经活动增加和副交感神经活动减少与慢性心力衰竭患者的疾病进展和不良预后相关。证明自主神经失衡和迷走神经功能障碍的标志物,如心率变异性和压力反射敏感性降低,尽管采用了现代治疗方法,但仍对慢性心力衰竭患者具有预后价值,这鼓励了针对迷走神经的神经调节策略的研究.然而,到目前为止,测试的方法没有得出定论。这篇综述旨在总结目前关于副交感神经系统在慢性心力衰竭中的作用的知识。描述病理生理背景,评估方法,和基本原理,limits,以及通过药物或生物电子设备刺激副交感神经的未来前景。