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Transvenous vagal nerve stimulation (VNS) in acute myocardial infarction (AMI) markedly reduces the infarction size and improves chronic cardiac function (LB670)
Author(s) -
Arimura Takahiro,
Saku Keita,
Kakino Takamori,
Akashi Takuya,
Takehara Takako,
Nishizaki Akiko,
Oga Yasuhiro,
Ikeda Masataka,
Fujii Kana,
Ide Tomomi,
Kishi Takuya,
Sunagawa Kenji
Publication year - 2014
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.28.1_supplement.lb670
Subject(s) - medicine , myocardial infarction , cardiology , infarction , cardiac function curve , hemodynamics , catheter , cardiac output , heart rate , heart failure , anesthesia , blood pressure , surgery
Background: Although VNS is known to have a powerful anti‐infarct effect, the technical difficulty associated with VNS precludes its application under emergent settings of AMI. We developed a novel technique where we stimulate the vagal system transvenously and evaluated how the VNS affects the infarction size and cardiac function in the long term. Method: We ligated a left anterior descending coronary artery for 3 hours, then reperfused. For transvenous VNS, we performed the field electrical stimulation by pacing catheter in the superior vena cava. VNS reduced mean heart rate about 20‐30% during I/R. One month after ischemia‐reperfusion, we compared the infarct size, hemodynamics and load insensitive cardiac function, i.e., end‐systolic elastance (Ees) (Millar pressure and sonomicrometric volumetry) with or without VNS treatment. Results: In comparison with no VNS, transvenous VNS significantly decreased the infarction size more than 80% (1.1±1.2 vs. 7.8±1.2cm2, p<0.05), doubled left ventricular Ees (6.5±1.7 vs. 13.2±0.6 mmHg/ml, p<0.05), and decreased NT‐pro BNP (3667±1637 vs. 843±256 pmol/ml, p<0.05). Conclusion: Transvenous VNS in AMI markedly reduces the infarct size and improves cardiac function in the chronic phase (4 weeks after AMI). Transvenous VNS would be a novel therapy of AMI to prevent heart failure in the long term.