Zafeiropoulos Stefanos, Ahmed Umair, Bikou Alexia, Mughrabi Ibrahim T, Stavrakis Stavros, Zanos Stavros
Elmezzi Graduate School of Molecular Medicine at Northwell Health, Manhasset, NY, USA; Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Manhasset, NY, USA.
Institute of Bioelectronic Medicine, Feinstein Institutes for Medical Research, Manhasset, NY, USA.
Trends Cardiovasc Med. 2024 Jul;34(5):327-337. doi: 10.1016/j.tcm.2023.07.003. Epub 2023 Jul 26.
Autonomic dysfunction and chronic inflammation contribute to the pathogenesis and progression of several cardiovascular diseases (CVD), such as heart failure with preserved ejection fraction, atherosclerotic CVD, pulmonary arterial hypertension, and atrial fibrillation. The vagus nerve provides parasympathetic innervation to the heart, vessels, and lungs, and is also implicated in the neural control of inflammation through a neuroimmune pathway involving the spleen. Stimulation of the vagus nerve (VNS) can in principle restore autonomic balance and suppress inflammation, with potential therapeutic benefits in these diseases. Although VNS ameliorated CVD in several animal models, early human studies have demonstrated variable efficacy. The purpose of this review is to discuss the rationale behind the use of VNS in the treatment of CVD, to critically review animal and human studies of VNS in CVD, and to propose possible means to overcome the challenges in the clinical translation of VNS in CVD.
自主神经功能障碍和慢性炎症促成了多种心血管疾病（CVD）的发病机制和进展，如射血分数保留的心力衰竭、动脉粥样硬化性心血管疾病、肺动脉高压和心房颤动。迷走神经为心脏、血管和肺提供副交感神经支配，并且还通过涉及脾脏的神经免疫途径参与炎症的神经控制。原则上，刺激迷走神经（VNS）可恢复自主神经平衡并抑制炎症，对这些疾病具有潜在的治疗益处。尽管VNS在多种动物模型中改善了心血管疾病，但早期人体研究显示出不同的疗效。本综述的目的是讨论使用VNS治疗心血管疾病背后的基本原理，批判性地回顾VNS在心血管疾病中的动物和人体研究，并提出可能的方法来克服VNS在心血管疾病临床转化中的挑战。
