The Recent Advances In The Treatment Of Heart Failure:the Ivabradine、ultrafiltration And Renal Sympathetic Denervation

Heart failure is a clinical syndrome caused by a variety of organic or functional heart diseases,with circulatory congestion, decreased left ventricular systolic function and sustained activation of the neuroendocrine system for the performance.It is a serious stage in the progressive development of all sorts of basic heart diseases.With the development of cardiovascular disease, the incidence of heart failure has increased year by year, resulting in more and more seriously social and economic issues.Although there are already multiple drugs and devices to solve the problem,new treatments are still an urgent need for the majority of patients with heart failure,medical technology still needs further development to solve this worldwide public health problem. Ivabradine, a new pure drug of lowering heart rate can significantly reduce the heart rate, obviously decrease the risk of re-hospitalization and cardiovascular death in patients with heart failure.Also, it can improve exercise tolerance and ventricular remodeling.Extracorporeal ultrafiltration pump blood from the peripheral or central venous by mechanical means to filter plasm,witch take advantage of hydrostatic pressure generated by a second pumpa.At last the pumpa transport the blood back.In this way,ultrafiltration can correct excessive load capacity and eliminate insufficient capacity or electrolyte abnormalities.It may normalize the capacity within the blood vessels and vascular space, and does not lead to electrolyte abnormalities or neurohormonal activation with decompensated heart failure patients.Compared with traditional diuretics, it can remove more sodium.But the timing 、mode and other issues of ultrafiltration still need more clinical studies to.investigate.Renal sympathetic denervation has beenapplied in patients with resistant hypertension.in the terms of heart failure, renal sympathetic denervation can modulatemyocardial morphology and function,inprome exercise tolerance by inhibiting the activation of sympathetic nervous system,.But its safety still need more clinical studies to verify.