心脏收缩性调节治疗心力衰竭的研究进展

Cardiac contractility modulation improves heart failure

心脏收缩性调节(cardiac contractility modulation,CCM)是一种新兴的非药物治疗心力衰竭技术,是心肌在绝对不应期接受的高能量电信号。CCM能够增强心肌收缩力,不增加心肌的氧需求量。与传统正性肌力药物作用机制不同,CCM通过改善心肌组织中异常表达的基因,及调节相关蛋白的功能,从而影响心肌细胞的钙循环,增强心肌的收缩力。临床研究中通过观察峰值氧摄取及明尼苏达生活质量评分发现CCM能改善心力衰竭患者的运动耐量及生活质量。

Cardiac contractility modulation（CCM）is a novel device-based therapy for heart failure that involves applying high energy electrical signals during absolute refractory period of the myocardial action potential.CCM has been shown to argument the strength of ventricular contraction independent of myocardial oxygen consumption.The mechanism underlying CCM is to shift abnormally expressed genes and positively affecting proteins that regulate calcium cycling,which is beyond the traditional pharmacological effects of inotropic agents.Clinical trials showed CCM improves exercise tolerance,as measured by VO2,peak and quality of life,assessed by the Minnesota Living with Heart Failure Questionnaire.