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Методы оценки симпатической активности у пациентов с рефрактерными к лечению системными гипертензиями
Методы оценки симпатической активности у пациентов с рефрактерными к лечению системными гипертензиями
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Аннотация
Несмотря на доступность современных лекарственных средств для лечения большинства сердечно-сосудистых заболеваний, наличие таких тяжелых недугов, как рефрактерная артериальная гипертония и легочная гипертензия, привело к разработке патогенетически обоснованных инвазивных методов лечения этих состояний. Выявление потенциальных ответчиков на этапе отбора больных позволит детальнее взглянуть на патогенез и развитие данных нозологий, определить предикторы эффективности альтернативных методов лечения, а также разработать протокол ведения этих пациентов. Исходя из этого, в статье рассматриваются разнообразные методы оценки активности симпатического отдела вегетативной нервной системы как основного звена патогенеза в развитии системных гипертензий.
Ключевые слова: рефрактерная артериальная гипертония, легочная гипертензия, вегетативная нервная система, симпатическая активность, радиочастотная денервация.
Key words: refractory hypertension, pulmonary hypertension, vegetative nervous system, sympathetic activity, radiofrequency denervation.
Ключевые слова: рефрактерная артериальная гипертония, легочная гипертензия, вегетативная нервная система, симпатическая активность, радиочастотная денервация.
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Key words: refractory hypertension, pulmonary hypertension, vegetative nervous system, sympathetic activity, radiofrequency denervation.
Полный текст
Список литературы
1. Papademetriou V, Doumas M, Tsioufis K. Renal Sympathetic Denervation for the Treatment of Difficult-to-Control or Resistant Hypertension. Int J Hypertens 2011; 2011: 196518; doi: 10.4061/2011/196518
2. Chen SL, Zhang YJ, Xie DJ et al. Percutaneous pulmonary artery denervation completely abolishes experimental pulmonary arterial hypertension in vivo. Eurointervention 2013; 9 (2): 269–76.
3. Chen SL, Zhang FF, Xu J et al. Pulmonary Artery Denervation to Treat Pulmonary Arterial Hypertension: The Single-Center, Prospective, First-in-Man PADN-1 Study (First-in-Man Pulmonary Artery Denervation for Treatment of Pulmonary Artery Hypertension) J Am Coll Cardiol 2013; 62 (12): 1092–100.
4. Bhatt DL, Kandzari DE, O'Neill WW et al. A controlled trial of renal denervation for resistant hypertension. N Engl J Med 2014; 370: 1393–401.
5. Patel HC, Rosen SD, Alistair L et al. Targeting the autonomic nervous system: Measuring autonomic function and novel devices for heart failure management. Int J Cardiol 2013; 170: 107–17.
6. Floras J. Sympathetic nervous system activation in human heart failure: clinical implications of an updated model. J Am Coll Cardiol 2009; 54: 375–85.
7. Buchheit M, Laursen PB, Ahmaidi S. Parasympathetic reactivation after repeated sprint exercise. Am J Physiol Heart Circ Physiol 2007; 293: H133–H141.
8. Guidelines. Heart rate variability.Standards of measurement, physiological in terpretation, and clinical use. Eur Heart J 1996; 17: 354–81.
9. Appel ML, Saul JP, Berger RD, Cohen RJ. Closed loop identification of cardio-vascular circulatory mechanisms. Computers in Cardiology 1989. Los Alamitos: IEEE Press, 1990; 3–7.
10. Corr PB, Yamada KA, Witkowski FX. Mechanisms controlling cardiac autonomic function and their relation to arrhythmogenesis. In: Fozzard HA, Haber E, Jennings RB et al. Heart and Cardiovascular System, New York: Raven Press, 1986; p. 1343–403.
11. Schwartz PJ, Priori SG. Sympathetic nervous system and cardiac arrhythmias. In: Zipes DP, Jalife J eds. Cardiac Electrophysiology. From Cell to Bedside. Philadelphia: WB Saunders, 1990; p. 330–43.
12. Levy MN, Schwartz PJ. Vagal control of the heart: Experimental basis and clinical implications. Armonk: Future, 1994.
13. Рябыкина Г.В., Соболев А.В. Вариабельность ритма сердца. М.: СтарКо, 1998.
14. Habib GB. Reappraisal of heart rate as a risk factor in the general population. Eur Heart J 1999; (Suppl. H): H2–H10.
15. Parati G, Saul GP, Di Rienzo M, Mancia G. Spectral analyses of blood pressure and heart rate variability in evaluating cardiovascular regulation. A critical appraisal. Hypertension 1995; 25: 1276–86.
16. Tsuji H, Venditti FJ, Manders ES et al. Reduced heart rate variability and mortality risk in an elderly cohort: The Framingham Study. Circulation 1994; 90: 878–83.
17. Аронов Д.М., Лупанов В.П. Функциональные пробы в кардиологии. М.: Медицина, 2003; с. 296.
18. Borresen J, Lambert MI. Autonomic control of heart rate during and after exercise: Measurements and implications for monitoring training status. Sports Med 2008; 38: 633–46.
19. Esler M, Jackman G, Bobik A et al. Norepinephrine kinetics in essential hypertension.Defective neuronal uptake of norepinephrine in some patients. Hypertension 1981; 3: 149–56.
20. Esler M, Hasking G, Willett I et al. Editorial review: noradrenaline release and sympathetic nervous system activity. J Hypertens 1985; 3: 117–29.
21. Esler M, Eikelis N, Schlaich M et al. Human sympathetic nerve biology: parallel influences of stress and epigenetics in essential hypertension and panic disorder. Ann NY Acad Sci 2008; 1148: 338–48.
22. Meredith IT, Eisenhofer G, Lambert GW et al. Plasma noradrenaline responses to head-up tilt are misleading in autonomic failure. Hypertension 1992; 19: 628–33.
23. Esler M, Jackman G, Bobik A et al. Determination of norepinephrine apparent release rate and clearance in humans. Life Sci 1979; 25: 1461–70.
24. Mancia, Grassi. Circ Res 2014; 114: 1804–14.
25. Esler M, Lambert E, Schlaich M. Point: Chronic activation of the sympathetic nervous system is the dominant contributor to systemic hypertension. J Appl Physiol 2010; 109: 1996–8.
26. Krum H, Schlaich MP, Whitbourn R et al. Catheter-based renal sympathetic denervation for resistant hypertension: a multicentre safety and proof-of-principle cohort study. Lancet 2009; 373: 1275–81.
27. Smith P et al. Am J Hypertens 2004; 17: 217–22.
28. Leimbach W, Wallin B, Victor R et al. Direct evidence from intraneural recordings for increased central sympathetic outflow in patients with heart failure. Circulation 1986; 73: 913–9.
29. Barretto A, Santos A, Munhoz R et al. Increased muscle sympathetic nerve activity predicts mortality in heart failure patients. Int J Cardiol 2009; 135: 302–7.
30. Schlaich M, Sobotka P, Krum H et al. Renal sympathetic-nerve ablation for uncontrolled hypertension. N Engl J Med 2009; 361: 932–3.
31. Bengel F. Imaging targets of the sympathetic nervous system of the heart: transla- tional considerations. J Nucl Med 2011; 52: 1167–70.
32. Mahfoud F et al. Effect of Renal Sympathetic Denervation on Glucose Metabolism in Patients With Resistant Hypertension. Circulation 2011; 123: 1940–6.
2. Chen SL, Zhang YJ, Xie DJ et al. Percutaneous pulmonary artery denervation completely abolishes experimental pulmonary arterial hypertension in vivo. Eurointervention 2013; 9 (2): 269–76.
3. Chen SL, Zhang FF, Xu J et al. Pulmonary Artery Denervation to Treat Pulmonary Arterial Hypertension: The Single-Center, Prospective, First-in-Man PADN-1 Study (First-in-Man Pulmonary Artery Denervation for Treatment of Pulmonary Artery Hypertension) J Am Coll Cardiol 2013; 62 (12): 1092–100.
4. Bhatt DL, Kandzari DE, O'Neill WW et al. A controlled trial of renal denervation for resistant hypertension. N Engl J Med 2014; 370: 1393–401.
5. Patel HC, Rosen SD, Alistair L et al. Targeting the autonomic nervous system: Measuring autonomic function and novel devices for heart failure management. Int J Cardiol 2013; 170: 107–17.
6. Floras J. Sympathetic nervous system activation in human heart failure: clinical implications of an updated model. J Am Coll Cardiol 2009; 54: 375–85.
7. Buchheit M, Laursen PB, Ahmaidi S. Parasympathetic reactivation after repeated sprint exercise. Am J Physiol Heart Circ Physiol 2007; 293: H133–H141.
8. Guidelines. Heart rate variability.Standards of measurement, physiological in terpretation, and clinical use. Eur Heart J 1996; 17: 354–81.
9. Appel ML, Saul JP, Berger RD, Cohen RJ. Closed loop identification of cardio-vascular circulatory mechanisms. Computers in Cardiology 1989. Los Alamitos: IEEE Press, 1990; 3–7.
10. Corr PB, Yamada KA, Witkowski FX. Mechanisms controlling cardiac autonomic function and their relation to arrhythmogenesis. In: Fozzard HA, Haber E, Jennings RB et al. Heart and Cardiovascular System, New York: Raven Press, 1986; p. 1343–403.
11. Schwartz PJ, Priori SG. Sympathetic nervous system and cardiac arrhythmias. In: Zipes DP, Jalife J eds. Cardiac Electrophysiology. From Cell to Bedside. Philadelphia: WB Saunders, 1990; p. 330–43.
12. Levy MN, Schwartz PJ. Vagal control of the heart: Experimental basis and clinical implications. Armonk: Future, 1994.
13. Рябыкина Г.В., Соболев А.В. Вариабельность ритма сердца. М.: СтарКо, 1998.
14. Habib GB. Reappraisal of heart rate as a risk factor in the general population. Eur Heart J 1999; (Suppl. H): H2–H10.
15. Parati G, Saul GP, Di Rienzo M, Mancia G. Spectral analyses of blood pressure and heart rate variability in evaluating cardiovascular regulation. A critical appraisal. Hypertension 1995; 25: 1276–86.
16. Tsuji H, Venditti FJ, Manders ES et al. Reduced heart rate variability and mortality risk in an elderly cohort: The Framingham Study. Circulation 1994; 90: 878–83.
17. Аронов Д.М., Лупанов В.П. Функциональные пробы в кардиологии. М.: Медицина, 2003; с. 296.
18. Borresen J, Lambert MI. Autonomic control of heart rate during and after exercise: Measurements and implications for monitoring training status. Sports Med 2008; 38: 633–46.
19. Esler M, Jackman G, Bobik A et al. Norepinephrine kinetics in essential hypertension.Defective neuronal uptake of norepinephrine in some patients. Hypertension 1981; 3: 149–56.
20. Esler M, Hasking G, Willett I et al. Editorial review: noradrenaline release and sympathetic nervous system activity. J Hypertens 1985; 3: 117–29.
21. Esler M, Eikelis N, Schlaich M et al. Human sympathetic nerve biology: parallel influences of stress and epigenetics in essential hypertension and panic disorder. Ann NY Acad Sci 2008; 1148: 338–48.
22. Meredith IT, Eisenhofer G, Lambert GW et al. Plasma noradrenaline responses to head-up tilt are misleading in autonomic failure. Hypertension 1992; 19: 628–33.
23. Esler M, Jackman G, Bobik A et al. Determination of norepinephrine apparent release rate and clearance in humans. Life Sci 1979; 25: 1461–70.
24. Mancia, Grassi. Circ Res 2014; 114: 1804–14.
25. Esler M, Lambert E, Schlaich M. Point: Chronic activation of the sympathetic nervous system is the dominant contributor to systemic hypertension. J Appl Physiol 2010; 109: 1996–8.
26. Krum H, Schlaich MP, Whitbourn R et al. Catheter-based renal sympathetic denervation for resistant hypertension: a multicentre safety and proof-of-principle cohort study. Lancet 2009; 373: 1275–81.
27. Smith P et al. Am J Hypertens 2004; 17: 217–22.
28. Leimbach W, Wallin B, Victor R et al. Direct evidence from intraneural recordings for increased central sympathetic outflow in patients with heart failure. Circulation 1986; 73: 913–9.
29. Barretto A, Santos A, Munhoz R et al. Increased muscle sympathetic nerve activity predicts mortality in heart failure patients. Int J Cardiol 2009; 135: 302–7.
30. Schlaich M, Sobotka P, Krum H et al. Renal sympathetic-nerve ablation for uncontrolled hypertension. N Engl J Med 2009; 361: 932–3.
31. Bengel F. Imaging targets of the sympathetic nervous system of the heart: transla- tional considerations. J Nucl Med 2011; 52: 1167–70.
32. Mahfoud F et al. Effect of Renal Sympathetic Denervation on Glucose Metabolism in Patients With Resistant Hypertension. Circulation 2011; 123: 1940–6.
2. Chen SL, Zhang YJ, Xie DJ et al. Percutaneous pulmonary artery denervation completely abolishes experimental pulmonary arterial hypertension in vivo. Eurointervention 2013; 9 (2): 269–76.
3. Chen SL, Zhang FF, Xu J et al. Pulmonary Artery Denervation to Treat Pulmonary Arterial Hypertension: The Single-Center, Prospective, First-in-Man PADN-1 Study (First-in-Man Pulmonary Artery Denervation for Treatment of Pulmonary Artery Hypertension) J Am Coll Cardiol 2013; 62 (12): 1092–100.
4. Bhatt DL, Kandzari DE, O'Neill WW et al. A controlled trial of renal denervation for resistant hypertension. N Engl J Med 2014; 370: 1393–401.
5. Patel HC, Rosen SD, Alistair L et al. Targeting the autonomic nervous system: Measuring autonomic function and novel devices for heart failure management. Int J Cardiol 2013; 170: 107–17.
6. Floras J. Sympathetic nervous system activation in human heart failure: clinical implications of an updated model. J Am Coll Cardiol 2009; 54: 375–85.
7. Buchheit M, Laursen PB, Ahmaidi S. Parasympathetic reactivation after repeated sprint exercise. Am J Physiol Heart Circ Physiol 2007; 293: H133–H141.
8. Guidelines. Heart rate variability.Standards of measurement, physiological in terpretation, and clinical use. Eur Heart J 1996; 17: 354–81.
9. Appel ML, Saul JP, Berger RD, Cohen RJ. Closed loop identification of cardio-vascular circulatory mechanisms. Computers in Cardiology 1989. Los Alamitos: IEEE Press, 1990; 3–7.
10. Corr PB, Yamada KA, Witkowski FX. Mechanisms controlling cardiac autonomic function and their relation to arrhythmogenesis. In: Fozzard HA, Haber E, Jennings RB et al. Heart and Cardiovascular System, New York: Raven Press, 1986; p. 1343–403.
11. Schwartz PJ, Priori SG. Sympathetic nervous system and cardiac arrhythmias. In: Zipes DP, Jalife J eds. Cardiac Electrophysiology. From Cell to Bedside. Philadelphia: WB Saunders, 1990; p. 330–43.
12. Levy MN, Schwartz PJ. Vagal control of the heart: Experimental basis and clinical implications. Armonk: Future, 1994.
13. Рябыкина Г.В., Соболев А.В. Вариабельность ритма сердца. М.: СтарКо, 1998.
14. Habib GB. Reappraisal of heart rate as a risk factor in the general population. Eur Heart J 1999; (Suppl. H): H2–H10.
15. Parati G, Saul GP, Di Rienzo M, Mancia G. Spectral analyses of blood pressure and heart rate variability in evaluating cardiovascular regulation. A critical appraisal. Hypertension 1995; 25: 1276–86.
16. Tsuji H, Venditti FJ, Manders ES et al. Reduced heart rate variability and mortality risk in an elderly cohort: The Framingham Study. Circulation 1994; 90: 878–83.
17. Аронов Д.М., Лупанов В.П. Функциональные пробы в кардиологии. М.: Медицина, 2003; с. 296.
18. Borresen J, Lambert MI. Autonomic control of heart rate during and after exercise: Measurements and implications for monitoring training status. Sports Med 2008; 38: 633–46.
19. Esler M, Jackman G, Bobik A et al. Norepinephrine kinetics in essential hypertension.Defective neuronal uptake of norepinephrine in some patients. Hypertension 1981; 3: 149–56.
20. Esler M, Hasking G, Willett I et al. Editorial review: noradrenaline release and sympathetic nervous system activity. J Hypertens 1985; 3: 117–29.
21. Esler M, Eikelis N, Schlaich M et al. Human sympathetic nerve biology: parallel influences of stress and epigenetics in essential hypertension and panic disorder. Ann NY Acad Sci 2008; 1148: 338–48.
22. Meredith IT, Eisenhofer G, Lambert GW et al. Plasma noradrenaline responses to head-up tilt are misleading in autonomic failure. Hypertension 1992; 19: 628–33.
23. Esler M, Jackman G, Bobik A et al. Determination of norepinephrine apparent release rate and clearance in humans. Life Sci 1979; 25: 1461–70.
24. Mancia, Grassi. Circ Res 2014; 114: 1804–14.
25. Esler M, Lambert E, Schlaich M. Point: Chronic activation of the sympathetic nervous system is the dominant contributor to systemic hypertension. J Appl Physiol 2010; 109: 1996–8.
26. Krum H, Schlaich MP, Whitbourn R et al. Catheter-based renal sympathetic denervation for resistant hypertension: a multicentre safety and proof-of-principle cohort study. Lancet 2009; 373: 1275–81.
27. Smith P et al. Am J Hypertens 2004; 17: 217–22.
28. Leimbach W, Wallin B, Victor R et al. Direct evidence from intraneural recordings for increased central sympathetic outflow in patients with heart failure. Circulation 1986; 73: 913–9.
29. Barretto A, Santos A, Munhoz R et al. Increased muscle sympathetic nerve activity predicts mortality in heart failure patients. Int J Cardiol 2009; 135: 302–7.
30. Schlaich M, Sobotka P, Krum H et al. Renal sympathetic-nerve ablation for uncontrolled hypertension. N Engl J Med 2009; 361: 932–3.
31. Bengel F. Imaging targets of the sympathetic nervous system of the heart: transla- tional considerations. J Nucl Med 2011; 52: 1167–70.
32. Mahfoud F et al. Effect of Renal Sympathetic Denervation on Glucose Metabolism in Patients With Resistant Hypertension. Circulation 2011; 123: 1940–6.
________________________________________________
2. Chen SL, Zhang YJ, Xie DJ et al. Percutaneous pulmonary artery denervation completely abolishes experimental pulmonary arterial hypertension in vivo. Eurointervention 2013; 9 (2): 269–76.
3. Chen SL, Zhang FF, Xu J et al. Pulmonary Artery Denervation to Treat Pulmonary Arterial Hypertension: The Single-Center, Prospective, First-in-Man PADN-1 Study (First-in-Man Pulmonary Artery Denervation for Treatment of Pulmonary Artery Hypertension) J Am Coll Cardiol 2013; 62 (12): 1092–100.
4. Bhatt DL, Kandzari DE, O'Neill WW et al. A controlled trial of renal denervation for resistant hypertension. N Engl J Med 2014; 370: 1393–401.
5. Patel HC, Rosen SD, Alistair L et al. Targeting the autonomic nervous system: Measuring autonomic function and novel devices for heart failure management. Int J Cardiol 2013; 170: 107–17.
6. Floras J. Sympathetic nervous system activation in human heart failure: clinical implications of an updated model. J Am Coll Cardiol 2009; 54: 375–85.
7. Buchheit M, Laursen PB, Ahmaidi S. Parasympathetic reactivation after repeated sprint exercise. Am J Physiol Heart Circ Physiol 2007; 293: H133–H141.
8. Guidelines. Heart rate variability.Standards of measurement, physiological in terpretation, and clinical use. Eur Heart J 1996; 17: 354–81.
9. Appel ML, Saul JP, Berger RD, Cohen RJ. Closed loop identification of cardio-vascular circulatory mechanisms. Computers in Cardiology 1989. Los Alamitos: IEEE Press, 1990; 3–7.
10. Corr PB, Yamada KA, Witkowski FX. Mechanisms controlling cardiac autonomic function and their relation to arrhythmogenesis. In: Fozzard HA, Haber E, Jennings RB et al. Heart and Cardiovascular System, New York: Raven Press, 1986; p. 1343–403.
11. Schwartz PJ, Priori SG. Sympathetic nervous system and cardiac arrhythmias. In: Zipes DP, Jalife J eds. Cardiac Electrophysiology. From Cell to Bedside. Philadelphia: WB Saunders, 1990; p. 330–43.
12. Levy MN, Schwartz PJ. Vagal control of the heart: Experimental basis and clinical implications. Armonk: Future, 1994.
13. Рябыкина Г.В., Соболев А.В. Вариабельность ритма сердца. М.: СтарКо, 1998.
14. Habib GB. Reappraisal of heart rate as a risk factor in the general population. Eur Heart J 1999; (Suppl. H): H2–H10.
15. Parati G, Saul GP, Di Rienzo M, Mancia G. Spectral analyses of blood pressure and heart rate variability in evaluating cardiovascular regulation. A critical appraisal. Hypertension 1995; 25: 1276–86.
16. Tsuji H, Venditti FJ, Manders ES et al. Reduced heart rate variability and mortality risk in an elderly cohort: The Framingham Study. Circulation 1994; 90: 878–83.
17. Аронов Д.М., Лупанов В.П. Функциональные пробы в кардиологии. М.: Медицина, 2003; с. 296.
18. Borresen J, Lambert MI. Autonomic control of heart rate during and after exercise: Measurements and implications for monitoring training status. Sports Med 2008; 38: 633–46.
19. Esler M, Jackman G, Bobik A et al. Norepinephrine kinetics in essential hypertension.Defective neuronal uptake of norepinephrine in some patients. Hypertension 1981; 3: 149–56.
20. Esler M, Hasking G, Willett I et al. Editorial review: noradrenaline release and sympathetic nervous system activity. J Hypertens 1985; 3: 117–29.
21. Esler M, Eikelis N, Schlaich M et al. Human sympathetic nerve biology: parallel influences of stress and epigenetics in essential hypertension and panic disorder. Ann NY Acad Sci 2008; 1148: 338–48.
22. Meredith IT, Eisenhofer G, Lambert GW et al. Plasma noradrenaline responses to head-up tilt are misleading in autonomic failure. Hypertension 1992; 19: 628–33.
23. Esler M, Jackman G, Bobik A et al. Determination of norepinephrine apparent release rate and clearance in humans. Life Sci 1979; 25: 1461–70.
24. Mancia, Grassi. Circ Res 2014; 114: 1804–14.
25. Esler M, Lambert E, Schlaich M. Point: Chronic activation of the sympathetic nervous system is the dominant contributor to systemic hypertension. J Appl Physiol 2010; 109: 1996–8.
26. Krum H, Schlaich MP, Whitbourn R et al. Catheter-based renal sympathetic denervation for resistant hypertension: a multicentre safety and proof-of-principle cohort study. Lancet 2009; 373: 1275–81.
27. Smith P et al. Am J Hypertens 2004; 17: 217–22.
28. Leimbach W, Wallin B, Victor R et al. Direct evidence from intraneural recordings for increased central sympathetic outflow in patients with heart failure. Circulation 1986; 73: 913–9.
29. Barretto A, Santos A, Munhoz R et al. Increased muscle sympathetic nerve activity predicts mortality in heart failure patients. Int J Cardiol 2009; 135: 302–7.
30. Schlaich M, Sobotka P, Krum H et al. Renal sympathetic-nerve ablation for uncontrolled hypertension. N Engl J Med 2009; 361: 932–3.
31. Bengel F. Imaging targets of the sympathetic nervous system of the heart: transla- tional considerations. J Nucl Med 2011; 52: 1167–70.
32. Mahfoud F et al. Effect of Renal Sympathetic Denervation on Glucose Metabolism in Patients With Resistant Hypertension. Circulation 2011; 123: 1940–6.
Авторы
В.А.Григин, Н.М.Данилов, О.В.Сагайдак, Г.В.Щелкова, И.Е.Чазова
ИКК им. А.Л.Мясникова ФГБУ РКНПК Минздрава России, Москва
ИКК им. А.Л.Мясникова ФГБУ РКНПК Минздрава России, Москва
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