An imbalance between cardiovascular parasympathetic and sympathetic activity towards sympathetic predominance has been implicated in the pathogenesis of treatment-resistant arterial hypertension and heart failure. Arterial baroreceptors control efferent cardiovascular autonomic activity and have, therefore, been recognized as potential treatment targets. Baroreflex activation therapy through electrical carotid sinus stimulation is a device-based approach to modulate cardiovascular autonomic activity. Electrical carotid sinus stimulation lowered blood pressure in various hypertensive animal models and improved cardiac remodeling and survival in preclinical models of heart failure. In human mechanistic profiling studies, electrical carotid sinus stimulation lowered blood pressure through sympathetic inhibition with substantial inter-individual variability. The first-generation device reduced blood pressure in controlled and uncontrolled clinical trials. Controlled clinical trials proving efficacy in blood pressure reduction in patients with hypertension do not exist for the currently available second-generation carotid sinus stimulator. Investigations in heart failure patients showed improved symptoms, quality of life, and natriuretic peptide biomarkers. Electrical carotid sinus stimulation is an interesting technology to modulate cardiovascular autonomic control. However, controlled trials with hard clinical endpoints are required.

中文翻译：

---

通过颈动脉窦电刺激进行压力反射激活疗法


心血管副交感神经和交感神经活动对交感神经优势的不平衡与难治性动脉高血压和心力衰竭的发病机制有关。动脉压力感受器控制传出的心血管自主神经活动，因此已被公认为潜在的治疗靶点。通过颈动脉窦电刺激进行的压力反射激活疗法是一种基于设备的方法，可调节心血管自主神经活动。颈动脉窦电刺激降低了各种高血压动物模型的血压，并改善了心力衰竭临床前模型的心脏重塑和生存率。在人类机制分析研究中，颈动脉窦电刺激通过交感神经抑制降低血压，个体间差异很大。第一代设备在对照和非对照临床试验中降低了血压。目前可用的第二代颈动脉窦刺激器尚不存在证明对高血压患者血压降低有效效果的对照临床试验。对心力衰竭患者的调查显示症状、生活质量和利钠肽生物标志物有所改善。颈动脉窦电刺激是一项调节心血管自主神经控制的有趣技术。然而，需要具有硬性临床终点的对照试验。