Gurel Nil Z, Hadaya Joseph, Ardell Jeffrey L
UCLA Neurocardiology Research Program of Excellence, Los Angeles, CA, United States of America; UCLA Cardiac Arrhythmia Center, UCLA Health System, Los Angeles, CA, United States of America.
UCLA Neurocardiology Research Program of Excellence, Los Angeles, CA, United States of America; UCLA Cardiac Arrhythmia Center, UCLA Health System, Los Angeles, CA, United States of America; Molecular, Cellular and Integrative Physiology Program, UCLA, Los Angeles, CA, United States of America.
Auton Neurosci. 2022 May;239:102944. doi: 10.1016/j.autneu.2022.102944. Epub 2022 Jan 20.
Cardiovascular and psychiatric disorders are among the most commonly treated conditions worldwide. Research in neurocardiology, psychiatry, and epidemiology have defined bidirectional relationships between psychiatric disorders and heart disease, affirming the role of impaired autonomic nervous system, or dysautonomia in the prognosis and development in these disorders. These studies have fueled rapid clinical translation of experimental findings, with potential to complement existing pharmacological therapies. In this review, we comprehensively discuss the state-of-the-art investigations and novel treatment approaches for stress-related dysautonomias, emphasizing the effects of stress on the cardiac neuronal hierarchy. Increasing evidence suggests that autonomic modulation stands as an attractive therapeutic strategy in the treatment of dysautonomias that could complement existing therapies and possibly reduce the burden of drug-related side effects and treatment-resistant conditions. Further investigations regarding treatment optimization, selectivity, usability, and ethical concerns are required.
心血管疾病和精神疾病是全球范围内最常治疗的疾病之一。神经心脏病学、精神病学和流行病学的研究已经明确了精神疾病与心脏病之间的双向关系，证实了自主神经系统受损或自主神经功能障碍在这些疾病的预后和发展中的作用。这些研究推动了实验结果的快速临床转化，有可能补充现有的药物治疗方法。在这篇综述中，我们全面讨论了与压力相关的自主神经功能障碍的最新研究和新的治疗方法，强调了压力对心脏神经元层级的影响。越来越多的证据表明，自主神经调节是治疗自主神经功能障碍的一种有吸引力的治疗策略，可以补充现有疗法，并可能减轻药物相关副作用和难治性疾病的负担。需要进一步研究治疗优化、选择性、可用性和伦理问题。
