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Neural Unloading using Intravenous Vagal Nerve Stimulation for Acute Myocardial Infarction (AMI) Improves Cardiac Function and Prevents Heart Failure in the Long Term
Author(s) -
Arimura Takahiro,
Saku Keita,
Kakino Takamori,
Akashi Takuya,
Murayama Yoshinori,
Nishikawa Takuya,
Takehara Takako,
Toyama Takeshi,
Kishi Takuya,
Ide Tomomi,
Sunagawa Kenji
Publication year - 2015
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.29.1_supplement.829.5
Subject(s) - medicine , preload , myocardial infarction , cardiology , heart failure , cardiac function curve , anesthesia , blood pressure , artery , infarction , hemodynamics
Background Vagal nerve stimulation (VNS) in AMI is known to have a powerful anti‐ischemic effect, but the technical difficulties associated with VNS limit its application under emergency settings. Furthermore, how the acute phase VNS translates into the long term benefit remains unknown. In this study, we developed a novel technique to stimulate the vagal nerves intravenously (iVNS), and evaluated how the iVNS impacts on the infarction size and cardiac function in the long term. Methods/results: In mongrel dogs, we ligated the left anterior descending coronary artery for 3 hours then reperfused (I/R). We delivered iVNS by an electrode catheter placed in the superior vena cava from 1.5 hours after the onset of ischemia to 1 hour after the reperfusion. During I/R iVNS significantly lowered HR (122±25 vs. 167±15 bpm, p <0.05), while did not change blood pressure. At 1 month after I/R, iVNS strikingly decreased the infarct size more than 60% (4.3±4.8 vs. 11.6±3.5%, p<0.05), lowered LVEDP (4.4±3.0 vs. 15.8±7.6 mmHg, p<0.05), and increased Ees (10.8±0.9 vs. 7.4±3.4 mmHg/ml, p <0.05), suggesting the preserved LV systolic function. Conclusion iVNS is capable of reducing the infarct size in AMI and improving cardiac function in the long term. This is a novel neural unloading strategy to prevent chronic heart failure.