自主神经再平衡与心力衰竭
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摘要
心力衰竭(简称心衰)是许多心脏疾病发展的最终、最严重的临床表现,神经激素激活和自主神经失衡(交感神经兴奋性增强、迷走神经张力降低)是其重要的病理生理特征。通过对自主神经系统的干预实现自主神经再平衡有望改变心衰的历史进程,有可能成为治疗心衰的新途径。
Heart failure(HF) is the ultimate and most serious clinical manifestation of many heart diseases. The activation of neurohormone and the imbalance of autonomic nerve(enhanced sympathetic excitability and decreased vagal tone) are important pathophysiological features. The rebalance of autonomic nervous system through the intervention of autonomic nervous system is expected to change the historical process of heart failure, which may become a new way to treat heart failure.
Heart failure(HF) is the ultimate and most serious clinical manifestation of many heart diseases. The activation of neurohormone and the imbalance of autonomic nerve(enhanced sympathetic excitability and decreased vagal tone) are important pathophysiological features. The rebalance of autonomic nervous system through the intervention of autonomic nervous system is expected to change the historical process of heart failure, which may become a new way to treat heart failure.
引文
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[2]YAP LB,QADIR F,NGUYEN STB,et al.The clinical benefit of cardiac resynchronization therapy for narrow QRS compared to broad QRS complex patients[J].International Journal of Cardiology,2015,183:178-179.
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[6]SCHWARTZ PJ,FERRARI GMD.Sympathetic-parasympathetic interaction in health and disease:abnormalities and relevance in heart failure[J].Heart Failure Reviews,2011,16(2):101-107.
[7]HOU Y,SCHERLAG BJ,LIN J,et al.Ganglionated plexi modulate extrinsic cardiac autonomic nerve input:effects on sinus rate,atrioventricular conduction,refractoriness,and inducibility of atrial fibrillation[J].Journal of the American College of Cardiology,2007,50(1):61-68.
[8]YU L,WANG S,ZHOU X,et al.Chronic intermittent low-level stimulation of tragus reduces cardiac autonomic remodeling and ventricular arrhythmia inducibility in a post-infarction canine model[J].JACC Clin Electrophysiol,2016,2(3):330-339.
[9]BABICK A,ELIMBAN V,ZIEROTH S,et al.Reversal of cardiac dysfunction and subcellular alterations by metoprolol in heart failure due to myocardial infarction[J].Journal of Cellular Physiology,2013,228(10):2063-2070.
[10]COLUCCI WS.The effects of norepinephrine on myocardial biology:Implications for the therapy of heart failure[J].Clinical Cardiology,1998,21(S1):20-24.
[11]PORT JD,BRISTOW MR.Altered beta-adrenergic receptor gene regulation and signaling in chronic heart failure[J].Journal of Molecular&Cellular Cardiology,2001,33(5):887-905.
[12]NIKOLAEV VO,MOSHKOV A,LYON AR,et al.β2-adrenergic receptor redistribution in heart failure changes cAMP compartmentation[J].Science,2010,327(5973):1653-1657.
[13]LYMPEROPOULOS A,BATHGATE A.Pharmacogenomics of the heptahelical receptor regulators G-protein-coupled receptor kinases and arrestins:the known and the unknown[J].Pharmacogenomics,2012,13(3):323-341.
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[18]RENGO G,LYMPEROPOULOS A,KOCH WJ.Future G proteincoupled receptor targets for treatment of heart failure[J].Curr Treat Options Cardiovasc Med,2009,11(4):328-338.
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[25]TCJL T.Plasma norepinephrine as a guide to prognosis in patients with chronic congestive heart failure[J].New England Journal of Medicine,1984,311(13):819-823.
[26]ESLER M,JENNINGS G,KORNER P,et al.Assessment of human sympathetic nervous system activity from measurements of norepinephrine turnover[J].Hypertension,1988,11(1):3-20.
[27]ESLER M,JENNINGS G,LAMBERT G,et al.Overflow of catecholamine neurotransmitters to the circulation:source,fate,and functions[J].Physiological Reviews,1990,70(4):963-985.
[28]HASKING GJ,ESLER MD,JENNINGS GL,et al.Norepinephrine spillover to plasma in patients with congestive heart failure:evidence of increased overall and cardiorenal sympathetic nervous activity[J].Circulation,1986,73(4):615-621.
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[30]COHN JN,PFEFFER MA,ROULEAU J,et al.Adverse mortality effect of central sympathetic inhibition with sustained-release moxonidine in patients with heart failure(MOXCON)[J].European Journal of Heart Failure,2003,5(5):659-667.
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[33]POOLE-WILSON PA,URETSKY BF,THYGESEN K,et al.Mode of death in heart failure:findings from the ATLAS trial[J].Heart,2003,89(1):42-48.
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[35]SCHLAICH MP,SOBOTKA PA,KRUM H,et al.Renal sympatheticnerve ablation for uncontrolled hypertension[J].New England Journal of Medicine,2009,361(9):932.
[36]DAVIES JE,MANISTY CH,PETRACO R,et al.First-in-man safety evaluation of renal denervation for chronic systolic heart failure:primary outcome from REACH-Pilot study[J].International Journal of Cardiology,2013,162(3):189-192.
[37]BRACK KE,COOTE JH,NG GA.Quantitative analysis of the parasympathetic innervation of the porcine heart[J].Heart Rhythm,2010,7(8):1113-1119.
[38]DICARLO L,LIBBUS I,AMURTHUR B,et al.Autonomic regulation therapy for the improvement of left ventricular function and heart failure symptoms:the ANTHEM-HF study[J].Journal of Cardiac Failure,2013,19(9):655-660.
[39]PREMCHAND RK,SHARMA K,MITTAL S,et al.Extended follow-up of patients with heart failure receiving autonomic regulation therapy in the ANTHEM-HF study[J].Journal of Cardiac Failure,2015,22(8):639-642.
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[43]ZHANG Y,POPOVIC ZB,BIBEVSKI S,et al.Chronic vagus nerve stimulation improves autonomic control and attenuates systemic inflammation and heart failure progression in a canine high-rate pacing model[J].Circ Heart Fail,2009,2(6):692-699.
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[45]SHEALY CN,MORTIMER JT,RESWICK JB.Electrical inhibition of pain by stimulation of the dorsal columns:preliminary clinical report[J].Anesthesia&Analgesia,1967,46(4):489-491.
[46]ISSA ZF,ZHOU X,UJHELYI MR,et al.Thoracic spinal cord stimulation reduces the risk of ischemic ventricular arrhythmias in a postinfarction heart failure canine model[J].Circulation,2005,111(24):3217-3220.
[47]KRUM H,SOBOTKA P,MAHFOUD F,et al.Device-based antihypertensive therapy:therapeutic modulation of the autonomic nervous system[J].Circulation,2011,123(2):209-215.
[48]SCHEFFERS IJ,KROON AA,SCHMIDLI J,et al.Novel baroreflex activation therapy in resistant hypertension:results of a European multi-center feasibility study[J].Journal of the American College of Cardiology,2010,56(15):1254-1258.
[49]LOHMEIER TE,IRWIN EDROSSING MA,SERDAR DJ,et al.Prolonged activation of the baroreflex produces sustained hypotension[J].Hypertension,2004,43(2):306-311.
[50]ZHANG Y,POPOVI?ZB,KUSUNOSE K,et al.Therapeutic effects of selective atrioventricular node vagal stimulation in atrial fibrillation and heart failure[J].Journal of Cardiovascular Electrophysiology,2013,24(1):86-91.
[51]HE B,LU Z,HE W,et al.Low-intensity atrial ganglionated plexi stimulation decreases the serum level of inflammatory factors in canine[J].Heart Lung&Circulation,2015,24(4):407-410.
[52]胡慧慧,罗达,秦智亮,等.心脏神经节丛刺激对急性心肌梗死后心力衰竭犬心脏功能及自主神经重构的影响[J].中国心脏起搏与心电生理杂志,2018,32(1):73-77.
[53]NEGRAO CE,MIDDLEKAUFF HR.Adaptations in autonomic function during exercise training in heart failure[J].Heart Failure Reviews,2008,13(1):51-60.
[54]FRAGA R,FRANCO FG,ROVEDA F,et al.Exercise training reduces sympathetic nerve activity in heart failure patients treated with carvedilol[J].European Journal of Heart Failure,2007,9(6-7):630-636.
[55]LEOSCO D,RENGO G,IACCARINO G,et al.Exercise training and beta-blocker treatment ameliorate age-dependent impairment of beta-adrenergic receptor signaling and enhance cardiac responsiveness to adrenergic stimulation[J].Am J Physiol Heart Circ Physiol,2007,293(3):H1596.
[56]COATS AJ,ADAMOPOULOS S,RADAELLI A,et al.Controlled trial of physical training in chronic heart failure.Exercise performance,hemodynamics,ventilation,and autonomic function[J].Circulation,1992,85(6):2119-2131.
[57]PI?A IL,LIN L,WEINFURT KP,et al.Hemoglobin,exercise training,and health status in patients with chronic heart failure(from the HF-ACTION randomized controlled trial)[J].American Journal of Cardiology,2013,112(7):971-976.
[58]周义义,李晓霞.运动对慢性心力衰竭大鼠心脏交感神经功能的调节--去甲肾上腺素转运蛋白的作用[J].体育科学,2012,32(3):67-73.
[59]何文博.心脏自主神经调控对室性心律失常的影响[D].武汉:武汉大学,2012.
[60]HE B,LU Z,HE W,et al.The effects of atrial ganglionated plexi stimulation on ventricular electrophysiology in a normal canine heart[J].Journal of Interventional Cardiac Electrophysiology,2013,37(1):1-8.
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[64]KARAVIDAS A,ARAPI SM,PYRGAKIS V,et al.Functional electrical stimulation of lower limbs in patients with chronic heart failure[J].Heart Failure Reviews,2010,15(6):563-579.
[65]D?RR M.Exercise training as a key component of heart failure therapy[J].Herz,2015,40(2):206-214.
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[2]YAP LB,QADIR F,NGUYEN STB,et al.The clinical benefit of cardiac resynchronization therapy for narrow QRS compared to broad QRS complex patients[J].International Journal of Cardiology,2015,183:178-179.
[3]MEHRA MR,KOBASHIGAWA J,STARLING R,et al.Listing criteria for heart transplantation:International Society for Heart and Lung Transplantation guidelines for the care of cardiac transplant candidates--2006[J].Journal of Heart&Lung Transplantation,2006,25(9):1024-1042.
[4]WANG H,HUANG BS,GANTEN D,et al.Prevention of sympathetic and cardiac dysfunction after myocardial infarction in transgenic rats deficient in brain angiotensinogen[J].Circulation Research,2004,94(6):843.
[5]LEENEN FH.Brain mechanisms contributing to sympathetic hyperactivity and heart failure[J].Circulation Research,2007,101(3):221-223.
[6]SCHWARTZ PJ,FERRARI GMD.Sympathetic-parasympathetic interaction in health and disease:abnormalities and relevance in heart failure[J].Heart Failure Reviews,2011,16(2):101-107.
[7]HOU Y,SCHERLAG BJ,LIN J,et al.Ganglionated plexi modulate extrinsic cardiac autonomic nerve input:effects on sinus rate,atrioventricular conduction,refractoriness,and inducibility of atrial fibrillation[J].Journal of the American College of Cardiology,2007,50(1):61-68.
[8]YU L,WANG S,ZHOU X,et al.Chronic intermittent low-level stimulation of tragus reduces cardiac autonomic remodeling and ventricular arrhythmia inducibility in a post-infarction canine model[J].JACC Clin Electrophysiol,2016,2(3):330-339.
[9]BABICK A,ELIMBAN V,ZIEROTH S,et al.Reversal of cardiac dysfunction and subcellular alterations by metoprolol in heart failure due to myocardial infarction[J].Journal of Cellular Physiology,2013,228(10):2063-2070.
[10]COLUCCI WS.The effects of norepinephrine on myocardial biology:Implications for the therapy of heart failure[J].Clinical Cardiology,1998,21(S1):20-24.
[11]PORT JD,BRISTOW MR.Altered beta-adrenergic receptor gene regulation and signaling in chronic heart failure[J].Journal of Molecular&Cellular Cardiology,2001,33(5):887-905.
[12]NIKOLAEV VO,MOSHKOV A,LYON AR,et al.β2-adrenergic receptor redistribution in heart failure changes cAMP compartmentation[J].Science,2010,327(5973):1653-1657.
[13]LYMPEROPOULOS A,BATHGATE A.Pharmacogenomics of the heptahelical receptor regulators G-protein-coupled receptor kinases and arrestins:the known and the unknown[J].Pharmacogenomics,2012,13(3):323-341.
[14]RENGO G,LYMPEROPOULOS A,LEOSCO D,et al.GRK2 as a novel gene therapy target in heart failure[J].Journal of Molecular&Cellular Cardiology,2011,50(5):785-792.
[15]RENGO G,PERRONE-FILARDI P,FEMMINELLA GD,et al.Targeting theβ-adrenergic receptor system through G-protein-coupled receptor kinase 2:a new paradigm for therapy and prognostic evaluation in heart failure:from bench to bedside[J].Circ Heart Fail,2012,5(3):385-391.
[16]ROCKMAN HA,KOCH WJ,LEFKOWITZ RJ.Seven-transmembrane-spanning receptors and heart function[J].Nature,2002,415(6868):206-212.
[17]FLORAS JS.The“unsympathetic”nervous system of heart failure[J].Circulation,2002,105(15):1753-1755.
[18]RENGO G,LYMPEROPOULOS A,KOCH WJ.Future G proteincoupled receptor targets for treatment of heart failure[J].Curr Treat Options Cardiovasc Med,2009,11(4):328-338.
[19]ULPHANI JS,CAIN JH,INDERYAS F,et al.Quantitative analysis of parasympathetic innervation of the porcine heart[J].Heart rhythm,2010,7(8):1113-1119.
[20]FOX K,BORER JS,CAMM AJ,et al.Resting heart rate in cardiovascular disease[J].Journal of the American College of Cardiology,2007,50(9):823-830.
[21]NEWTON GE,PARKER AB,LANDZBERG JS,et al.Muscarinic receptor modulation of basal and beta-adrenergic stimulated function of the failing human left ventricle[J].Journal of Clinical Investigation,2011,98(12):2756-2763.
[22]MEREDITH IT,EISENHOFER G,LAMBERT GW,et al.Cardiac sympathetic nervous activity in congestive heart failure.Evidence for increased neuronal norepinephrine release and preserved neuronal uptake[J].Circulation,1993,88(1):136-145.
[23]MANN DL,KENT RL,PARSONS B,et al.Adrenergic effects on the biology of the adult mammalian cardiocyte[J].Circulation,1992,85(2):790-804.
[24]KIMURA K,KANAZAWA HM,KAWAGUCHI MH,et al.Norepinephrine-induced nerve growth factor depletion causes cardiac sympathetic denervation in severe heart failure[J].Autonomic Neuroscience,2010,156(1-2):27-35.
[25]TCJL T.Plasma norepinephrine as a guide to prognosis in patients with chronic congestive heart failure[J].New England Journal of Medicine,1984,311(13):819-823.
[26]ESLER M,JENNINGS G,KORNER P,et al.Assessment of human sympathetic nervous system activity from measurements of norepinephrine turnover[J].Hypertension,1988,11(1):3-20.
[27]ESLER M,JENNINGS G,LAMBERT G,et al.Overflow of catecholamine neurotransmitters to the circulation:source,fate,and functions[J].Physiological Reviews,1990,70(4):963-985.
[28]HASKING GJ,ESLER MD,JENNINGS GL,et al.Norepinephrine spillover to plasma in patients with congestive heart failure:evidence of increased overall and cardiorenal sympathetic nervous activity[J].Circulation,1986,73(4):615-621.
[29]ANAND IS,FISHER LD,CHIANG YT,et al.Changes in brain natriuretic peptide and norepinephrine over time and mortality and morbidity in the Valsartan Heart Failure Trial(Val-HeFT)[J].Circulation,2003,107(9):1278-1283.
[30]COHN JN,PFEFFER MA,ROULEAU J,et al.Adverse mortality effect of central sympathetic inhibition with sustained-release moxonidine in patients with heart failure(MOXCON)[J].European Journal of Heart Failure,2003,5(5):659-667.
[31]CAMPBELL DJ,AGGARWAL A,ESLER M,et al.beta-blockers,angiotensinⅡ,and ACE inhibitors in patients with heart failure[J].Lancet,2001,358(9293):1609-1610.
[32]POCOCK SJ,WANG D,PFEFFER MA,et al.Predictors of mortality and morbidity in patients with chronic heart failure[J].European Heart Journal,2006,27(1):65-75.
[33]POOLE-WILSON PA,URETSKY BF,THYGESEN K,et al.Mode of death in heart failure:findings from the ATLAS trial[J].Heart,2003,89(1):42-48.
[34]B?HM M,SWEDBERG K,KOMAJDA M,et al.Heart rate as a risk factor in chronic heart failure(SHIFT):the association between heart rate and outcomes in a randomised placebo-controlled trial[J].Lancet,2010,376(9744):886-894.
[35]SCHLAICH MP,SOBOTKA PA,KRUM H,et al.Renal sympatheticnerve ablation for uncontrolled hypertension[J].New England Journal of Medicine,2009,361(9):932.
[36]DAVIES JE,MANISTY CH,PETRACO R,et al.First-in-man safety evaluation of renal denervation for chronic systolic heart failure:primary outcome from REACH-Pilot study[J].International Journal of Cardiology,2013,162(3):189-192.
[37]BRACK KE,COOTE JH,NG GA.Quantitative analysis of the parasympathetic innervation of the porcine heart[J].Heart Rhythm,2010,7(8):1113-1119.
[38]DICARLO L,LIBBUS I,AMURTHUR B,et al.Autonomic regulation therapy for the improvement of left ventricular function and heart failure symptoms:the ANTHEM-HF study[J].Journal of Cardiac Failure,2013,19(9):655-660.
[39]PREMCHAND RK,SHARMA K,MITTAL S,et al.Extended follow-up of patients with heart failure receiving autonomic regulation therapy in the ANTHEM-HF study[J].Journal of Cardiac Failure,2015,22(8):639-642.
[40]LI M,ZHENG C,SATO T,et al.Vagal nerve stimulation markedly improves long-term survival after chronic heart failure in rats[J].Circulation,2004,109(1):120-124.
[41]赵爽,唐闽,张澍.迷走神经刺激治疗心力衰竭研究进展[J].心血管病学进展,2016,37(5):499-502.
[42]SABBAH HN,ILSAR I,ZARETSKY A,et al.Vagus nerve stimulation in experimental heart failure[J].Heart Failure Reviews,2011,16(2):171-178.
[43]ZHANG Y,POPOVIC ZB,BIBEVSKI S,et al.Chronic vagus nerve stimulation improves autonomic control and attenuates systemic inflammation and heart failure progression in a canine high-rate pacing model[J].Circ Heart Fail,2009,2(6):692-699.
[44]DE FERRARI GM,CRIJNS HJGM,BORGGREFE M,et al.Chronic vagus nerve stimulation:a new and promising therapeutic approach for chronic heart failure[J].European Heart Journal,2011,32(7):847.
[45]SHEALY CN,MORTIMER JT,RESWICK JB.Electrical inhibition of pain by stimulation of the dorsal columns:preliminary clinical report[J].Anesthesia&Analgesia,1967,46(4):489-491.
[46]ISSA ZF,ZHOU X,UJHELYI MR,et al.Thoracic spinal cord stimulation reduces the risk of ischemic ventricular arrhythmias in a postinfarction heart failure canine model[J].Circulation,2005,111(24):3217-3220.
[47]KRUM H,SOBOTKA P,MAHFOUD F,et al.Device-based antihypertensive therapy:therapeutic modulation of the autonomic nervous system[J].Circulation,2011,123(2):209-215.
[48]SCHEFFERS IJ,KROON AA,SCHMIDLI J,et al.Novel baroreflex activation therapy in resistant hypertension:results of a European multi-center feasibility study[J].Journal of the American College of Cardiology,2010,56(15):1254-1258.
[49]LOHMEIER TE,IRWIN EDROSSING MA,SERDAR DJ,et al.Prolonged activation of the baroreflex produces sustained hypotension[J].Hypertension,2004,43(2):306-311.
[50]ZHANG Y,POPOVI?ZB,KUSUNOSE K,et al.Therapeutic effects of selective atrioventricular node vagal stimulation in atrial fibrillation and heart failure[J].Journal of Cardiovascular Electrophysiology,2013,24(1):86-91.
[51]HE B,LU Z,HE W,et al.Low-intensity atrial ganglionated plexi stimulation decreases the serum level of inflammatory factors in canine[J].Heart Lung&Circulation,2015,24(4):407-410.
[52]胡慧慧,罗达,秦智亮,等.心脏神经节丛刺激对急性心肌梗死后心力衰竭犬心脏功能及自主神经重构的影响[J].中国心脏起搏与心电生理杂志,2018,32(1):73-77.
[53]NEGRAO CE,MIDDLEKAUFF HR.Adaptations in autonomic function during exercise training in heart failure[J].Heart Failure Reviews,2008,13(1):51-60.
[54]FRAGA R,FRANCO FG,ROVEDA F,et al.Exercise training reduces sympathetic nerve activity in heart failure patients treated with carvedilol[J].European Journal of Heart Failure,2007,9(6-7):630-636.
[55]LEOSCO D,RENGO G,IACCARINO G,et al.Exercise training and beta-blocker treatment ameliorate age-dependent impairment of beta-adrenergic receptor signaling and enhance cardiac responsiveness to adrenergic stimulation[J].Am J Physiol Heart Circ Physiol,2007,293(3):H1596.
[56]COATS AJ,ADAMOPOULOS S,RADAELLI A,et al.Controlled trial of physical training in chronic heart failure.Exercise performance,hemodynamics,ventilation,and autonomic function[J].Circulation,1992,85(6):2119-2131.
[57]PI?A IL,LIN L,WEINFURT KP,et al.Hemoglobin,exercise training,and health status in patients with chronic heart failure(from the HF-ACTION randomized controlled trial)[J].American Journal of Cardiology,2013,112(7):971-976.
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