优化经皮耳廓迷走神经刺激对健康人和心衰患者心脏自律神经特征的影响。

IF 2.3 4区 医学 Q3 BIOPHYSICS Physiological measurement Pub Date : 2024-07-17 DOI:10.1088/1361-6579/ad5ef6
Roberto Maestri, Gian Domenico Pinna, Elena Robbi, Chiara Cogliati, Arianna Bartoli, Giuseppina Gambino, Giuseppe Rengo, Nicola Montano, Maria Teresa La Rovere
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引用次数: 0

摘要

目的:确定经皮迷走神经刺激(tVNS)的最佳频率和刺激部位,以诱导健康受试者(HS)和心力衰竭(HF)患者的自律神经特征(心率(HR)、心率变异性(HRV))发生急性变化。我们设计了三项单盲、随机、交叉研究:(1)比较 25 Hz 和 10 Hz 左侧 tVNS 的急性效应(n= 29,年龄 60 ± 7 岁);(2)比较研究 1 中确定的最佳频率下左侧和右侧 tVNS 的急性效应(n= 28,年龄 61 ± 7 岁);(3)比较确定的最佳刺激方案与假刺激对 HS 和 HF 患者的急性效应(分别为 n= 30,年龄 59 ± 5 岁和 n= 32,年龄 63 ± 7 岁)。主要结果:在研究 1 中,在降低心率(分别为 -1.0±1.2bpm,p< 0.001 和 -0.5±1.6bpm)和诱导迷走神经效应(RMSSD 和高频功率显著增加)方面,25 Hz 左侧外耳刺激比 10 Hz 刺激更有效。在研究 2 中,刺激左耳后心率下降幅度大于右耳(分别为 -0.9 ± 1.5 bpm,p< 0.01 和 -0.3 ± 1.4 bpm)。在对 HS 进行的第 3 项研究中,频率为 25 Hz 的左侧 tVNS 能显著降低心率,而假刺激则不能(分别为 -1.1 ± 1.2 bpm,p< 0.01 和 -0.2 ± 2.9 bpm)。意义:25 Hz 的左侧 tVNS 可有效调节 HS 患者的心血管自主神经控制(心率、心率变异),但对 HF 患者无效(NCT05789147)。
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Impact of optimized transcutaneous auricular vagus nerve stimulation on cardiac autonomic profile in healthy subjects and heart failure patients.

Objective.To determine the optimal frequency and site of stimulation for transcutaneous vagus nerve stimulation (tVNS) to induce acute changes in the autonomic profile (heart rate (HR), heart rate variability (HRV)) in healthy subjects (HS) and patients with heart failure (HF).Approach.We designed three single-blind, randomized, cross-over studies: (1) to compare the acute effect of left tVNS at 25 Hz and 10 Hz (n= 29, age 60 ± 7 years), (2) to compare the acute effect of left and right tVNS at the best frequency identified in study 1 (n= 28 age 61 ± 7 years), and (3) to compare the acute effect of the identified optimal stimulation protocol with sham stimulation in HS and HF patients (n= 30, age 59 ± 5 years, andn= 32, age 63 ± 7 years, respectively).Main results.In study 1, left tragus stimulation at 25 Hz was more effective than stimulation at 10 Hz in decreasing HR (-1.0 ± 1.2 bpm,p< 0.001 and -0.5 ± 1.6 bpm, respectively) and inducing vagal effects (significant increase in RMSSD, and HF power). In study 2, the HR reduction was greater with left than right tragus stimulation (-0.9 ± 1.5 bpm,p< 0.01 and -0.3 ± 1.4 bpm, respectively). In study 3 in HS, left tVNS at 25 Hz significantly reduced HR, whereas sham stimulation did not (-1.1 ± 1.2 bpm,p< 0.01 and -0.2 ± 2.9 bpm, respectively). In HF patients, both active and sham stimulation produced negligible effects.Significance.Left tVNS at 25 Hz is effective in acute modulation of cardiovascular autonomic control (HR, HRV) in HS but not in HF patients (NCT05789147).

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来源期刊
Physiological measurement
Physiological measurement 生物-工程:生物医学
CiteScore
5.50
自引率
9.40%
发文量
124
审稿时长
3 months
期刊介绍: Physiological Measurement publishes papers about the quantitative assessment and visualization of physiological function in clinical research and practice, with an emphasis on the development of new methods of measurement and their validation. Papers are published on topics including: applied physiology in illness and health electrical bioimpedance, optical and acoustic measurement techniques advanced methods of time series and other data analysis biomedical and clinical engineering in-patient and ambulatory monitoring point-of-care technologies novel clinical measurements of cardiovascular, neurological, and musculoskeletal systems. measurements in molecular, cellular and organ physiology and electrophysiology physiological modeling and simulation novel biomedical sensors, instruments, devices and systems measurement standards and guidelines.
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