Vagus nerve stimulation improves left ventricular function in a canine model of chronic heart failure
Vagus nerve stimulation improves left ventricular function in a canine model of chronic heart failure
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DOI：
10.1093/eurjhf/hft118
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发表时间：
2013-12-01
影响因子：
18.2
通讯作者：
Sabbah, Hani N.
中科院分区：
文献类型：
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作者：
Hamann, Jason J.;Ruble, Stephen B.;Sabbah, Hani N.
自主神经功能障碍是慢性心力衰竭（HF）的一个特征。本研究测试了慢性开环迷走神经电刺激（VNS）改善慢性心力衰竭犬的左室结构和功能的假设。26只因冠状动脉内微栓塞产生心力衰竭（EF 35）的犬在右颈迷走神经周围植入双极袖带电极，并连接到可植入脉冲发生器。这些犬只参加对照（n = 7）与 VNS 治疗（n = 7）或交叉研究，交叉发生在 3 个月时（C VNS，n 6；VNS C，n 6）。经过 6 个月的 VNS 治疗后，与对照相比，左心室射血分数 (LVEF) 和左心室收缩末期容积 (ESV) 显着改善（EF 对照 4.6 0.9 对比 VNS 6.0 1.6，P < 0.001）和（ESV 对照 8.3 1.8 mL 对比 VNS 3.0 2.3 mL，P < 0.002）。血浆和组织生物标志物也得到改善。在交叉研究中， VNS 还导致 EF 显着改善 和ESV与对照相比（EF对照2.3 0.65 vs. VNS 6.7 1.1 mL，P < 0.001，ESV对照3.2 1.2 mL vs. VNS 4.0 0.9 mL，P < 0.001）。对照组在 3 个月时开始治疗，EF（对照 4.7 ± 1.4 对比 VNS 3.7 ± 0.74，P < 0.001）和 ESV（对照 1.5 ± 1.2 mL 对比 NS）显着改善 5.5±1.6mL，P=0.003）6个月。在患有心力衰竭的犬中，与未接受治疗的对照动物相比，长期、开环低水平的VNS治疗可改善左心室收缩功能，防止进行性左心室扩大，并改善心力衰竭的生物标志物。
Autonomic dysfunction is a feature of chronic heart failure (HF). This study tested the hypothesis that chronic open-loop electrical vagus nerve stimulation (VNS) improves LV structure and function in canines with chronic HF.Twenty-six canines with HF (EF 35) produced by intracoronary microembolizations were implanted with a bipolar cuff electrode around the right cervical vagus nerve and connected to an implantable pulse generator. The canines were enrolled in Control (n 7) vs. VNS therapy (n 7) or a crossover study, with crossovers occurring at 3 months (C VNS, n 6; VNS C, n 6). After 6 months of VNS, LVEF and LV end-systolic volume (ESV) were significantly improved compared with Control (EF Control 4.6 0.9 vs. VNS 6.0 1.6, P 0.001) and (ESV Control 8.3 1.8 mL vs. VNS 3.0 2.3 mL, P 0.002. Plasma and tissue biomarkers were also improved. In the crossover study, VNS also resulted in a significant improvement in EF and ESV compared with Control (EF Control 2.3 0.65 vs. VNS 6.7 1.1 mL, P 0.001 and ESV Control 3.2 1.2 mL vs. VNS 4.0 0.9 mL, P 0.001). Initiation of therapy in the Control group at 3 months resulted in a significant improvement in EF (Control 4.7 1.4 vs. VNS 3.7 0.74, P 0.001) and ESV (Control 1.5 1.2 mL vs. NS 5.5 1.6 mL, P 0.003) by 6 months.In canines with HF, long-term, open-looped low levels of VNS therapy improves LV systolic function, prevents progressive LV enlargement, and improves biomarkers of HF when compared with control animals that did not receive therapy.