Manolis A J, Poulimenos L E, Kallistratos M S, Gavras I, Gavras H
Department of Cardiology, Asklepeion General Hospital, 1 Vas. Pavlou Ave, Voula 16673, Greece.
Curr Vasc Pharmacol. 2014 Jan;12(1):4-15. doi: 10.2174/15701611113119990140.
From the first description of its anatomy by T. Willis to the novel therapeutic manipulations, it is unanimously recognized that the sympathetic nervous system (SNS) holds a crucial role in cardiovascular homeostasis. The introduction of sophisticated techniques, as microneurography and regional norepinephrine spillover provided the evidence for the role of sympathetic overactivity in various cardiovascular disease entities. Sympathetic activation is common in patients with essential hypertension and contributes to initiation, maintenance and progression of the disease and it contributes to the manifestation of its major complications. A considerable body of evidence relates SNS overactivity with high sodium intake in experimental animals and humans and the underlying mechanisms have nowadays been elucidated. SNS activity is more pronounced in patients with resistant hypertension and there are several conditions that lead to this phenomenon, as older age, kidney disease, obesity and metabolic syndrome, mental stress and sleep apnea. SNS overactivity holds also a key physiopathological role in heart failure, acute coronary syndromes and arrhythmias. Moreover, inhibition of sympathetic overactivity by various means, including central SNS suppressing drugs, peripheral alpha- and beta- adrenergic receptor blockers, or novel approaches as renal sympathetic denervation have been used successfully in the treatment of all these disorders.
从T. 威利斯对其解剖结构的首次描述到新颖的治疗手段，人们一致认为交感神经系统（SNS）在心血管稳态中起着关键作用。微神经ography和区域去甲肾上腺素溢出等先进技术的引入，为交感神经过度活跃在各种心血管疾病实体中的作用提供了证据。交感神经激活在原发性高血压患者中很常见，并且有助于疾病的起始、维持和进展，还会导致其主要并发症的出现。大量证据表明，在实验动物和人类中，交感神经系统过度活跃与高钠摄入有关，目前其潜在机制已得到阐明。在难治性高血压患者中，交感神经系统活动更为明显，有几种情况会导致这种现象，如老年、肾脏疾病、肥胖和代谢综合征、精神压力和睡眠呼吸暂停。交感神经过度活跃在心力衰竭、急性冠状动脉综合征和心律失常中也起着关键的生理病理作用。此外，通过各种手段抑制交感神经过度活跃，包括中枢交感神经系统抑制药物、外周α和β肾上腺素能受体阻滞剂，或肾交感神经去支配等新方法，已成功用于治疗所有这些疾病。
