Treatment of chronic heart failure in the 21st century: A new era of biomedical engineering has come

Chronic Diseases and Translational Medicine - Tập 5 - Trang 75-88 - 2019
Chun-Song Hu1,2, Qing-Hua Wu2, Da-Yi Hu3,4, Tengiz Tkebuchava5
1Jiangxi Academy of Medical Science, Hospital of Nanchang University, Nanchang University, Nanchang, Jiangxi 330006, China
2Institute of Cardiovascular Diseases, Nanchang University, Nanchang, Jiangxi 330006, China
3Department of Cardiology, People's Hospital of Peking University, Beijing 100044, China
4Department of Cardiology, Tongji University School of Medicine, Shanghai 200032, China
5Boston TransTec, LLC, Boston, MA 02459, USA

Tóm tắt

AbstractChronic heart failure (CHF) is a challenging burden on public health. Therapeutic strategies for CHF have developed rapidly in the past decades from conventional medical therapy, which mainly includes administration of angiotensin‐converting enzyme inhibitors, angiotensin receptor blockers, beta‐blockers, and aldosterone antagonists, to biomedical engineering methods, which include interventional engineering, such as percutaneous balloon mitral valvotomy, percutaneous coronary intervention, catheter ablation, biventricular pacing or cardiac resynchronization therapy (CRT) and CRT‐defibrillator use, and implantable cardioverter defibrillator use; mechanical engineering, such as left ventricular assistant device use, internal artery balloon counterpulsation, cardiac support device use, and total artificial heart implantation; surgical engineering, such as coronary artery bypass graft, valve replacement or repair of rheumatic or congenital heart diseases, and heart transplantation (HT); regenerate engineering, which includes gene therapy, stem cell transplantation, and tissue engineering; and rehabilitating engineering, which includes exercise training, low‐salt diet, nursing, psychological interventions, health education, and external counterpulsation/enhanced external counterpulsation in the outpatient department. These biomedical engineering therapies have greatly improved the symptoms of CHF and life expectancy. To date, pharmacotherapy, which is based on evidence‐based medicine, large‐scale, multi‐center, randomized controlled clinical trials, is still a major treatment option for CHF; the current interventional and mechanical device engineering treatment for advanced CHF is not enough owing to its individual status. In place of HT or the use of a total artificial heart, stem cell technology and gene therapy in regenerate engineering for CHF are very promising. However, each therapy has its advantages and disadvantages, and it is currently possible to select better therapeutic strategies for patients with CHF according to cost‐efficacy analyses of these therapies. Taken together, we think that a new era of biomedical engineering for CHF has begun.

Tài liệu tham khảo

10.1093/eurheartj/ehx026 10.1093/eurheartj/eht514 10.1056/NEJMoa1409077 10.1016/j.jacc.2017.08.057 10.1016/S0140-6736(16)32049-9 10.1016/j.jacc.2013.05.035 10.1016/S0140-6736(14)61373-8 10.1136/bmj.i1855 10.1056/NEJMoa1510774 10.1056/NEJMoa1609758 10.1016/S0140-6736(14)61402-1 10.1016/S0140-6736(14)62225-X 10.1056/NEJMoa1506115 10.1038/nrcardio.2016.35 10.1186/s12933-016-0381-x 10.1093/eurheartj/ehw110 10.1186/s12933-016-0419-0 10.1161/CIRCULATIONAHA.116.021887 10.1001/jamacardio.2017.2275 10.1016/j.diabet.2016.05.006 10.1007/s00125-016-4134-x 10.1007/s00059-016-4496-3 10.1161/CIRCULATIONAHA.117.030012 10.1038/nrcardio.2017.211 10.1093/eurheartj/ehx668 10.1001/jama.2016.7635 10.1056/NEJMoa1514859 10.1016/S0002-9149(98)01012-1 10.1001/jama.289.20.2685 10.1016/j.ijcard.2003.10.002 10.1056/NEJMoa1401426 10.1056/NEJMoa1306687 10.1001/jama.2013.8641 10.1016/S0002-9149(02)03340-4 10.1056/NEJMoa1707855 10.1007/s11886-012-0299-1 10.1136/heartjnl-2014-306835 10.1161/01.CIR.98.22.2383 10.1056/NEJMoa1602954 10.1056/NEJMoa1610426 10.12659/MSMBR.898897 10.1093/ejcts/ezw073 10.1097/MAT.0000000000000471 10.1097/MAT.0b013e31829f0e52 10.1002/ccd.27650 10.1159/000176394 10.1161/hc37t1.094525 10.1016/S0022-5223(19)39906-4 10.1056/NEJM198402023100501 10.1111/j.1525-1594.1991.tb00770.x 10.1111/j.1525-1594.1996.tb00682.x Pavie A., 1997, CardioWest, a complete artificial heart, the French experience, Chirurgie, 121, 685 10.1016/S0140-6736(15)00723-0 10.1016/S0140-6736(16)00704-2 10.1016/S0022-4804(02)00039-2 10.1016/j.transproceed.2004.03.075 10.1161/hc0802.105564 10.1161/hc3601.095574 10.1001/jamacardio.2016.0008 Hu C.S., 2003, Progress in chimeric vector and chimeric gene based cardiovascular gene therapy, Mol Cardiol China, 3, 344 10.1038/35070587 Hu C.S., 2003, Preliminary treatment effect of autologous bone marrow transplantation on dilated cardiomyopathy and heart failure (5 cases report), Mol Cardiol China, 3, 14 10.1161/01.CIR.0000070596.30552.8B 10.1001/jama.2013.3527 10.1016/S0140-6736(16)30137-4 10.1093/eurheartj/ehy012 10.1161/01.CIR.0000128596.49339.05 10.1161/01.RES.0000073844.41372.38 10.1038/nm912 10.1161/01.CIR.0000016722.37138.F2 10.1111/j.1527-5299.2002.01731.x 10.1136/bmj.328.7441.711-b Hambrecht R., 2004, Physical exercise as treatment strategy, Herz, 29, 381 10.1016/j.jacc.2012.06.036 10.1161/CIRCRESAHA.113.301684 10.1016/S0002-8703(03)00314-4 10.1016/S0195-668X(02)00822-9 10.1093/eurheartj/ehr504 10.1093/eurheartj/ehr448 10.1136/bmj.i1010 10.1093/eurheartj/ehr306 10.1016/j.jchf.2015.11.010 10.1016/j.hrtlng.2016.03.004 10.1002/ejhf.989 10.1016/j.ijcard.2013.01.005 10.5114/aoms.2012.29523 10.1016/j.cdtm.2016.03.001 Hu D.Y., 2016, New guidelines and evidence for prevention and treatment of dyslipidemia and atherosclerotic cardiovascular disease in China, Chronic Dis Transl Med, 3, 73 10.1016/j.cdtm.2016.11.011 10.1016/j.cdtm.2016.10.001 10.1016/j.cdtm.2015.06.005 10.1016/j.cdtm.2017.05.002 10.1093/eurheartj/ehy293
Thông tin
Thông tin xuất bản

Chronic Diseases and Translational Medicine

Tập 5

75-88

Thông tin tác giả