肾动脉消融治疗慢性心力衰竭研究进展

慢性心力衰竭是一种复杂的临床症状群，是多种心血管疾病的共同转归。交感神经持续过度激活是其发生及发展的重要机制，多项临床及动物实验研究均表明，肾脏神经在交感神经活动中起着促进和传递的作用。2009年，Krum教授首次尝试利用导管靶向消融肾动脉周围的交感神经，从而降低全身过度激活的交感活性，达到治疗顽固性高血压的目的。这项新的治疗策略在有效地控制血压的同时还能有效降低心脏、肾脏以及肌肉组织等多个器官系统的交感神经活性，并能调节水盐代谢，改善心室重构和心脏功能，减轻机体高交感神经活性所导致的多器官损害。虽然其中具体的机制尚未明了，但我们有理由相信肾动脉消融在治疗高血压、慢性心力衰竭、代谢综合征等交感神经慢性过度激活的疾病有广阔的应用前景。

Progress of renal artery ablation in treatment of chronic heart failure

Chronic heart failure is a complex clinical syndrome, and a common outcome of multiple cardiovascular diseases. Chronic excessive activation of sympathetic nerves is an important mechanism for heart failure. A number of clinical and animal studies have indicated that, renal nerves play an indispensable role in sympathetic activity. In 2009, Prof. Krum for the first time used catheter-based renal sympathetic denervation to reduce chronic excessive activation of sympathetic nerves, and thus treat drug-resistant hypertension. This new approach not only reduces hypertension but also significantly decreases the sympathetic nerve activity in the heart, kidneys, muscles and other organs. It also can regulate water salt metabolism, improve the ventricular remodeling and cardiac function, and alleviate multiple organ damages induced by sympathetic overactivity. Although the mechanisms mediating these changes remain unclear, these observations demonstrate that targeted sympathetic ablation therapies have enormous ootential in the treatment of cardinvn~ular and m~.t~hc, lio A;~ ;~-~A ...：~-1. ： t_.： ~ ~.