Guzik Mateusz, Urban Szymon, Iwanek Gracjan, Biegus Jan, Ponikowski Piotr, Zymliński Robert
Institute of Heart Diseases, Wroclaw Medical University, 50-556 Wroclaw, Poland.
J Clin Med. 2022 Jul 25;11(15):4303. doi: 10.3390/jcm11154303.
Heart failure (HF) constitutes a significant clinical problem and is associated with a sizeable burden for the healthcare system. Numerous novel techniques, including device interventions, are investigated to improve clinical outcome. A review of the most notable currently studied devices targeting pathophysiological processes in HF was performed. Interventions regarding autonomic nervous system imbalance, i.e., baroreflex activation therapy; vagus, splanchnic and cardiopulmonary nerves modulation; respiratory disturbances, i.e., phrenic nerve stimulation and synchronized diaphragmatic therapy; decongestion management, i.e., the Reprieve system, transcatheter renal venous decongestion system, Doraya, preCardia, WhiteSwell and Aquapass, are presented. Each segment is divided into subsections: potential pathophysiological target, existing evidence and weaknesses or unexplained issues. Novel therapeutic devices represent great potential in HF therapy management; however, further evidence is necessary to fully evaluate their utility.
心力衰竭(HF)是一个重大的临床问题,给医疗保健系统带来了相当大的负担。人们研究了许多新技术,包括器械干预,以改善临床结局。本文对目前研究最显著的针对HF病理生理过程的器械进行了综述。介绍了针对自主神经系统失衡的干预措施,即压力反射激活疗法;迷走神经、内脏神经和心肺神经调制;呼吸紊乱,即膈神经刺激和同步膈肌治疗;充血管理,即Reprieve系统、经导管肾静脉充血系统、Doraya、preCardia、WhiteSwell和Aquapass。每个部分都分为小节:潜在的病理生理靶点、现有证据以及弱点或未解释的问题。新型治疗器械在HF治疗管理中具有巨大潜力;然而,需要更多证据来全面评估它们的效用。