Chronic vagal nerve stimulation exerts additional beneficial effects on the beta-blocker-treated failing heart
Chronic vagal nerve stimulation exerts additional beneficial effects on the beta-blocker-treated failing heart
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DOI：
10.1007/s12576-018-0646-0
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发表时间：
2019-03-01
影响因子：
2.3
通讯作者：
Sugimachi, Masaru
中科院分区：
文献类型：
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作者：
Li, Meihua;Zheng, Can;Sugimachi, Masaru
迷走神经刺激（VNS）可诱导慢性心力衰竭（CHF）患者心动过缓。我们假设，如果抗β-肾上腺素能作用是VNS的主要作用，则β受体阻滞剂将覆盖VNS对CHF的有益作用。本研究探讨了VNS对美托洛尔治疗的CHF大鼠心脏重塑的影响。心肌梗死后2周，存活大鼠随机分为假刺激组（SS）、美托洛尔假刺激组（SSM）和美托洛尔VNS组（VSM）。与SS组相比，SSM和VSM组的心率显著降低。血流动力学评价结果显示，VSM大鼠心脏泵血功能较SSM大鼠好，心脏指数较高，心脏重量较SSM大鼠低。与SSM相比，VSM还与较低的血浆脑钠肽和去甲肾上腺素水平相关。与SS组相比，VSM组而非SSM组的50天生存率有所提高。结果表明，迷走神经刺激可能发挥其有益的作用，对衰竭的心脏独立的抗β-肾上腺素能机制。
Vagal nerve stimulation (VNS) induces bradycardia in chronic heart failure (CHF). We hypothesized that beta-blocker would cover the beneficial effects of VNS on CHF if the anti-beta-adrenergic effect was the main VNS effect. This study investigated the effects of VNS on cardiac remodeling in rats with CHF treated with metoprolol. Two weeks after myocardial infarction, surviving rats were randomly assigned to groups of sham stimulation (SS), sham stimulation with metoprolol (SSM), or VNS with metoprolol (VSM). Compared to the SS group, heart rate was significantly reduced in the SSM and VSM groups. Hemodynamic assessments showed that VSM rats maintained better cardiac pump function and presented higher cardiac index and lower heart weight than SSM rats. VSM was also associated with lower plasma brain natriuretic peptide and norepinephrine levels than SSM. VSM but not SSM improved the 50-day survival rate compared with the SS group. The results suggest that VNS may exert its beneficial effects on the failing heart independently of its anti-beta-adrenergic mechanism.