Cardiovascular Section, Department of Internal Medicine, Heart Rhythm Institute, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
Life Sci. 2023 Oct 15;331:122069. doi: 10.1016/j.lfs.2023.122069. Epub 2023 Sep 4.
Mitigation of cardiac autonomic dysregulation by neuromodulation technologies is emerging as a new therapeutic modality of heart failure (HF). This recent progress has necessitated the identification of a biomarker for the quantification of sympathovagal balance, the potential target of 'neuromodulation' strategies. The currently available autonomic nervous system assessment parameters do not truly reflect the sympathovagal balance of the ventricle. Protein kinase A (PKA) is an intracellular enzyme that plays a major role in the pathophysiology of functional and structural ventricular remodeling in HF. Interestingly, sympathetic and parasympathetic activations exert reciprocal influence on the activity of PKA. The current review attempts to evaluate the potential concept and feasibility of using in vitro assessment of PKA activity as a marker of sympathovagal balance in HF.
神经调节技术对心脏自主神经失调的缓解作用正成为心力衰竭（HF）的一种新治疗模式。这一最新进展需要确定一种生物标志物来量化交感神经-迷走神经平衡，这是“神经调节”策略的潜在靶点。目前可用的自主神经系统评估参数并不能真正反映心室的交感神经-迷走神经平衡。蛋白激酶 A（PKA）是一种细胞内酶，在 HF 中功能性和结构性心室重构的病理生理学中起主要作用。有趣的是，交感神经和副交感神经的激活对 PKA 的活性产生相互影响。本综述试图评估使用体外 PKA 活性评估作为 HF 中交感神经-迷走神经平衡标志物的潜在概念和可行性。
