切除颈动脉体治疗慢性收缩性心力衰竭。

Carotid body removal for treatment of chronic systolic heart failure.

作者信息

Niewiński Piotr, Janczak Dariusz, Rucinski Artur, Jazwiec Przemyslaw, Sobotka Paul A, Engelman Zoar J, Fudim Marat, Tubek Stanislaw, Jankowska Ewa A, Banasiak Waldemar, Hart Emma C J, Paton Julian F R, Ponikowski Piotr

机构信息

Department of Cardiology, Centre for Heart Disease, 4th Military Hospital, Wroclaw, Poland.

出版信息

Int J Cardiol. 2013 Oct 3;168(3):2506-9. doi: 10.1016/j.ijcard.2013.03.011. Epub 2013 Mar 29.

DOI:10.1016/j.ijcard.2013.03.011

PMID:23541331

Abstract

BACKGROUND

Augmented reflex response from peripheral chemoreceptors characterises chronic heart failure (CHF), contributes to autonomic imbalance and exercise intolerance and predicts poor outcome.

METHODS AND RESULTS

We present a case of a 56-year-old male patient with ischaemic CHF, who underwent surgical, unilateral carotid body resection to reduce peripheral chemosensitivity. At 2-month and 6-month follow-ups, we document a persistent decrease in peripheral chemosensitivity accompanied by an improvement in exercise capacity, sleep disordered breathing and quality of life. Autonomic balance was favourably affected as evidenced by improved heart rate variability and augmented cardiac baroreflex sensitivity. There were no procedure-related adverse events.

CONCLUSIONS

Denervation of a carotid body may offer a clinical strategy to restore autonomic balance and improve morbidity in heart failure (NCT01653821).

摘要

背景

外周化学感受器的反射反应增强是慢性心力衰竭（CHF）的特征，导致自主神经失衡和运动不耐受，并预示不良预后。

方法与结果

我们报告一例56岁男性缺血性CHF患者，该患者接受了手术，单侧颈动脉体切除术以降低外周化学敏感性。在2个月和6个月的随访中，我们记录到外周化学敏感性持续下降，同时运动能力、睡眠呼吸紊乱和生活质量得到改善。自主神经平衡受到有利影响，心率变异性改善和心脏压力反射敏感性增强证明了这一点。没有与手术相关的不良事件。