Imamura Teruhiko, Kinugawa Koichiro, Nitta Daisuke, Komuro Issei
Department of Therapeutic Strategy for Heart Failure, Graduate School of Medicine, The University of Tokyo.
Int Heart J. 2016 Jul 27;57(4):511-4. doi: 10.1536/ihj.16-014. Epub 2016 Jul 7.
Adaptive servo-ventilation support and Waon therapy are recently developed non-pharmacological and noninvasive therapies for patients with heart failure refractory to guideline-directed medical therapy. These therapies decrease both preload and afterload, increase cardiac output, and appear to ameliorate autonomic nerve activity. However, the time course of autonomic nerve activity during these therapies remains unclear. We performed heart rate variability analysis using the MemCalc power spectral density method (MemCalc system; Suwa Trust Co, Tokyo) to assess autonomic nerve activity during adaptive servo-ventilation support and Waon therapy in two different cases and determined the time course of autonomic nerve activity during these therapies. During both therapies, we found a drastic increase in parasympathetic nerve activity and continuous suppression of sympathetic nerve activity. Heart rate variability analysis using the MemCalc method may be promising for the assessment of the efficacy of various treatments, including adaptive servo-ventilation support and Waon therapy, from the viewpoint of autonomic nerve activity.
适应性伺服通气支持和温热疗法是最近开发的针对难治性心力衰竭患者的非药物和非侵入性治疗方法,这些患者对指南指导的药物治疗无效。这些疗法可降低前负荷和后负荷,增加心输出量,并且似乎能改善自主神经活动。然而,这些疗法期间自主神经活动的时间进程仍不清楚。我们使用MemCalc功率谱密度方法(MemCalc系统;诹访信托公司,东京)进行心率变异性分析,以评估在两个不同病例中适应性伺服通气支持和温热疗法期间的自主神经活动,并确定这些疗法期间自主神经活动的时间进程。在两种疗法期间,我们发现副交感神经活动急剧增加,交感神经活动持续受到抑制。从自主神经活动的角度来看,使用MemCalc方法进行心率变异性分析可能有助于评估包括适应性伺服通气支持和温热疗法在内的各种治疗方法的疗效。