Acute right-sided transcutaneous vagus nerve stimulation improves cardio-vagal baroreflex gain in patients with chronic heart failure.

IF 3.9 3区医学 Q1 CLINICAL NEUROLOGY Clinical Autonomic Research Pub Date : 2024-10-14 DOI:10.1007/s10286-024-01074-9

Francesco Gentile, Alberto Giannoni, Alessandro Navari, Eleonora Degl'Innocenti, Michele Emdin, Claudio Passino

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Abstract

Purpose: The aim of this paper is to investigate the acute effects of short-term transcutaneous vagus nerve stimulation (tVNS) on cardio-vagal baroreflex gain and heart rate variability in patients with chronic heart failure (CHF).

Methods: A total of 16 adults with CHF and left ventricular ejection fraction (LVEF) < 50% in sinus rhythm were enrolled (65 ± 8 years, 63% men, LVEF 40 ± 5%, 88% on beta-blockers, 50% on quadruple CHF therapy). Over a single experimental session, after a 10-min baseline recording, each patient underwent two trials of 10-min tVNS (Parasym Device, 200 µs, 30 Hz, 1 mA below discomfort threshold) at either the right or left tragus in a randomized order, separated by a 10-min recovery.

Results: Compared with baseline, tVNS did not affect heart rate, blood pressure, and respiratory rate (p > 0.05), and no patients complained of discomfort or any adverse effect. Right-sided tVNS was associated with a significant increase in cardio-vagal baroreflex gain (from 5.6 ± 3.1 to 7.5 ± 3.8 ms/mmHg, ∆ 1.9 ± 1.6 ms/mmHg, p < 0.001), while no change was observed with left-sided tVNS (∆ 0.5 ± 2.0 ms/mmHg, p = 0.914). These findings were independent of stimulation-side order (excluding any carry-over effect) and consistent across sex, LVEF category, and HF etiology subgroups (p-value for interaction > 0.05).

Conclusions: Acute right-sided tVNS increases cardio-vagal baroreflex gain in patients with CHF and LVEF < 50%, with no tolerability concerns.

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急性右侧经皮迷走神经刺激可改善慢性心力衰竭患者的心迷走气压增益。

目的：本文旨在研究短期经皮迷走神经刺激（tVNS）对慢性心力衰竭（CHF）患者的心迷走巴反射增益和心率变异性的急性影响：共有 16 名患有慢性心力衰竭且左心室射血分数（LVEF）较高的成人接受了研究：与基线相比，tVNS 不影响心率、血压和呼吸频率（P > 0.05），没有患者抱怨不适或任何不良反应。右侧 tVNS 与心迷走气压反射增益的显著增加有关（从 5.6 ± 3.1 到 7.5 ± 3.8 ms/mmHg，∆ 1.9 ± 1.6 ms/mmHg，P 0.05）：急性右侧tVNS可增加CHF和LVEF患者的心-迷走巴反射增益。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Autonomic Research 医学-临床神经学

CiteScore

7.40

自引率

6.90%

发文量

审稿时长

>12 weeks

期刊介绍： Clinical Autonomic Research aims to draw together and disseminate research work from various disciplines and specialties dealing with clinical problems resulting from autonomic dysfunction. Areas to be covered include: cardiovascular system, neurology, diabetes, endocrinology, urology, pain disorders, ophthalmology, gastroenterology, toxicology and clinical pharmacology, skin infectious diseases, renal disease. This journal is an essential source of new information for everyone working in areas involving the autonomic nervous system. A major feature of Clinical Autonomic Research is its speed of publication coupled with the highest refereeing standards.