医学
心力衰竭
压力反射
刺激
迷走神经电刺激
胆碱能的
自主神经系统
副交感神经系统
交感神经系统
副交感神经病理模拟物
迷走神经
心脏病学
内科学
重症监护医学
神经科学
血压
心率
心理学
毒蕈碱乙酰胆碱受体
受体
作者
Gisele Lopes Cavalcante,Fernanda Brognara,Lucas Vaz de Castro Oliveira,Renata Maria Lataro,M Durand,Aldeídia Pereira de Oliveira,Antônio Cláudio Lucas da Nóbrega,Hélio César Salgado,João Paulo J. Sabino
摘要
Abstract Systemic arterial hypertension and heart failure are cardiovascular diseases that affect millions of individuals worldwide. They are characterized by a change in the autonomic nervous system balance, highlighted by an increase in sympathetic activity associated with a decrease in parasympathetic activity. Most therapeutic approaches seek to treat these diseases by medications that attenuate sympathetic activity. However, there is a growing number of studies demonstrating that the improvement of parasympathetic function, by means of pharmacological or electrical stimulation, can be an effective tool for the treatment of these cardiovascular diseases. Therefore, this review aims to describe the advances reported by experimental and clinical studies that addressed the potential of cholinergic stimulation to prevent autonomic and cardiovascular imbalance in hypertension and heart failure. Overall, the published data reviewed demonstrate that the use of central or peripheral acetylcholinesterase inhibitors is efficient to improve the autonomic imbalance and hemodynamic changes observed in heart failure and hypertension. Of note, the baroreflex and the vagus nerve activation have been shown to be safe and effective approaches to be used as an alternative treatment for these cardiovascular diseases. In conclusion, pharmacological and electrical stimulation of the parasympathetic nervous system has the potential to be used as a therapeutic tool for the treatment of hypertension and heart failure, deserving to be more explored in the clinical setting.
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