Vagal nerve stimulation markedly improves long-term survival after chronic heart failure in rats
Vagal nerve stimulation markedly improves long-term survival after chronic heart failure in rats
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DOI：
10.1161/01.cir.0000105721.71640.da
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发表时间：
2004-01-06
期刊：
影响因子：
37.8
通讯作者：
Sunagawa, K
中科院分区：
文献类型：
--
作者：
Li, M;Zheng, C;Sunagawa, K
背景-心脏迷走神经活动减弱和心率加快预示着心肌梗死后慢性心力衰竭(CHF)的高死亡率。在大面积心肌梗死后慢性电刺激迷走神经对CHF动物模型心脏重构和长期存活的影响。方法和结果-结扎左冠状动脉两周后，存活的大鼠被随机分为迷走神经刺激组和假刺激组。用植入式微型射频电刺激器刺激CHF大鼠右侧迷走神经6周。调整每只大鼠的电刺激强度，使心率每分钟降低20到30次。治疗组大鼠左室舒张末压显著低于未治疗组(17.1±/-5.9vs23.5+/-4.2 mm Hg，P<；0.05)，左室内压最大dp/dt显著高于未治疗组(4152±/-237vs2987+/-192 mm Hg/S，P<；0.05)。心泵功能的改善伴随着标准化双心室重量的下降(2.75+/-0.25比3.14+/-0.22g/kg，P<；0.01)。虽然未治疗组的140d存活率只有一半，但迷走神经刺激显著提高了存活率(86%比50%，P=0.008)。迷走神经刺激治疗可使死亡相对危险度降低73%。结论迷走神经刺激通过预防泵血衰竭和心脏重构，显著提高CHF大鼠的长期存活率。
Background - Diminished cardiac vagal activity and higher heart rate predict a high mortality rate of chronic heart failure (CHF) after myocardial infarction. We investigated the effects of chronic electrical stimulation of the vagus nerve on cardiac remodeling and long-term survival in an animal model of CHF after large myocardial infarction.Methods and Results - Two weeks after the ligation of the left coronary artery, surviving rats were randomized to vagal- and sham-stimulated groups. Using an implantable miniature radio-controlled electrical stimulator, we stimulated the right vagal nerve of CHF rats for 6 weeks. The intensity of electrical stimulation was adjusted for each rat, so that the heart rate was lowered by 20 to 30 beats per minute. The treated rats had significantly lower left ventricular end-diastolic pressure (17.1 +/- 5.9 versus 23.5 +/- 4.2 mm Hg, P < 0.05) and higher maximum dp/dt of left ventricular pressure (4152 +/- 237 versus 2987 +/- 192 mm Hg/s, P < 0.05) than the untreated rats. Improvement of cardiac pumping function was accompanied by a decrease in normalized biventricular weight (2.75 +/- 0.25 versus 3.14 +/- 0.22 g/kg, P < 0.01). Although the 140-day survival of the untreated group was only half, vagal stimulation markedly improved the survival rate (86% versus 50%, P = 0.008). Vagal stimulation therapy achieved a 73% reduction in a relative risk ratio of death.Conclusions - Vagal nerve stimulation markedly improved the long-term survival of CHF rats through the prevention of pumping failure and cardiac remodeling.