文章摘要
陈若菡,陈柯萍.迷走神经刺激在慢性心力衰竭中的应用[J].南京医科大学学报,2016,(4):406~410
迷走神经刺激在慢性心力衰竭中的应用
Application of vagus nerve simulation in patients with chronic heart failure
投稿时间:2016-04-05  
DOI:10.7655/NYDXBNS20160405
中文关键词: 迷走神经刺激  心力衰竭
英文关键词: vague nerve stimulation  heart failure
基金项目:
作者单位
陈若菡 中国医学科学院北京协和医学院国家心血管病中心,心血管疾病国家重点实验室,阜外医院心律失常中心,北京 100037 
陈柯萍 中国医学科学院北京协和医学院国家心血管病中心,心血管疾病国家重点实验室,阜外医院心律失常中心,北京 100037 
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中文摘要:
      在心衰的发生和发展过程中,不仅存在交感神经的激活,而且存在副交感神经功能减退。动物研究显示迷走神经刺激有助于逆转心衰的心室重构,提高迷走神经张力有助于增加心衰患者心肌内NO合成?减少炎症因子和增加缝隙蛋白的表达。CardioFit 和 ANTHEM-HF等临床研究证实迷走神经刺激(vague nerve stimulation,VNS)的安全性及有效性。但新近发布的NECRAR-HF研究未能证实VNS在改善心脏重构和提高心功能的作用。更大样本量的随机对照研究有助于进一步证实VNS的疗效。
英文摘要:
      Chronic heart failure (HF) is associated with autonomic dysregulation characterized by as sustained increase in sympathetic drive and by withdrawal of parasympathetic activity. Experimental data have demonstrated that stimulation of the vague nerve is able to reverse ventricular remodeling of the failing heart. There is also evidence that increasing parasympathetic activity may stimulate the production of nitric oxide, reduce the devastating inflammatory process and increase the myocardial expression of gap junction proteins in HF. Several clinical trial s including CardioFit and ANTHEM-HF have proven the safety and effectivity of vague nerve stimulation (VNS) in HF patient. But recently published data from NECTAR-HF trial failed to demonstrate a significant effect on cardiac remodeling and function capacity in HF patient. A prospective randomized trial with a larger patient cohort is needed to confirm the beneficial results of VNS.
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