Hanna Peter, Shivkumar Kalyanam, Ardell Jeffrey L
David Geffen School of Medicine, University of California Los Angeles (UCLA) Los Angeles, CA, USA.
Card Fail Rev. 2018 Aug;4(2):92-98. doi: 10.15420/cfr.2018.20.2.
Heart failure (HF) is associated with significant morbidity and mortality. The disease is characterised by autonomic imbalance with increased sympathetic activity and withdrawal of parasympathetic activity. Despite the use of medical therapies that target, in part, the neurohormonal axis, rates of HF progression, morbidity and mortality remain high. Emerging therapies centred on neuromodulation of autonomic control of the heart provide an alternative device-based approach to restoring sympathovagal balance. Preclinical studies have proven favourable, while clinical trials have had mixed results. This article highlights the importance of understanding structural/functional organisation of the cardiac nervous system as mechanistic-based neuromodulation therapies evolve.
心力衰竭（HF）与显著的发病率和死亡率相关。该疾病的特征是自主神经失衡，交感神经活动增加，副交感神经活动减弱。尽管使用了部分针对神经激素轴的药物治疗，但HF的进展率、发病率和死亡率仍然很高。以心脏自主控制的神经调节为中心的新兴疗法提供了一种基于设备的替代方法来恢复交感迷走神经平衡。临床前研究已证明其具有优势，而临床试验结果则喜忧参半。随着基于机制的神经调节疗法的发展，本文强调了理解心脏神经系统结构/功能组织的重要性。
