经导管消融选择性去肾交感神经治疗——未来心力衰竭治疗的热点

Catheter-based Selective Renal Artery Sympathetic Denervation——A Hot Spot of Managing Heart Failure in the Future

心力衰竭是各种心脏疾病的终末阶段。近几十年来,心力衰竭的治疗得到了一定的发展,但仍不能明显改善患者生存率,且需长期大量服药,严重影响患者生活质量。大量的研究显示:交感神经系统激活在心力衰竭的发生发展中扮演着重要角色。自上世纪40、50年代,学者们已开始进行去交感神经治疗心力衰竭的尝试,但碍于当时设备和技术的限制,治疗效果不尽人意。可喜的是,澳大利亚的权威学者近几年在美国心脏病学会/美国心脏协会心血管年会上介绍了一种安全、有效的新型去肾交感神经的方法,即经导管消融选择性去肾交感神经。该研究证实此方法可以明显降低全身交感活性。那么经导管消融去肾交感神经治疗能否成为未来心力衰竭治疗的热点呢?现将对去交感神经治疗心力衰竭的现状和进展做一综述。

Heart failure is the end-stage of serious heart disease. In recent decades, the heart failure treatment has gained some devel- opment, but still can＇ t significantly improve survival rate. The patients need to take a large amount of medication, and influence seriously the life quality of patients. Some study demonstrated that the somatic sympathetic nerves drive plays an important role in the development of heart failure. The sympathetic nerves denervation therapy has been researched since 1940 ~ 1950s, but the result is not satisfactory because of the restriction of poor technology. On the 2009 ACC/AHA cardiovascular annual conference, Krum MD introduced a new therapeutic method： the catheter-based renal artery ablation renal sympathetic nerves denervation. The HTN-2 Trail prove that the new method is safe and effective. The study （HTN-2） has been confirmed that the method can obviously reduce the whole body sympathetic activity. Will the catheter-based selective renal artery sympathetic denervation be a hot spot of managing heart failure in the future？ This paper will review the sympathetic nerves denervation therapy in heart failure.