Vagus nerve stimulation improves left ventricular function in a canine model of chronic heart failure. (December 2013)

• Record Type: Journal Article
• Authors: Hamann, Jason J.; Ruble, Stephen B.; Stolen, Craig; Wang, Mengjun; Gupta, Ramesh C.; Rastogi, Sharad; Sabbah, Hani N.
• Is Part Of: European journal of heart failure. Volume 15:Number 12(2013)
• Page Start: 1319
• Page End: 1326
• Publication Date: 2013-12
• Subjects: Heart failure -- Periodicals; Heart Failure -- Periodicals; Insuffisance cardiaque -- Périodiques; Heart failure; Periodicals; 616.129005
• DOI: 10.1093/eurjhf/hft118
• Languages: English
• ISSNs: 1388-9842

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ejhfhft118-1-sec-0001" sec-type="section"> <title>Aims</title> <p>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.</p> </sec> <sec id="ejhfhft118-1-sec-0002" sec-type="section"> <title>Methods and results</title> <p>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 (<italic>n</italic> = 7) vs. VNS therapy (<italic>n</italic> = 7) or a crossover study, with crossovers occurring at 3 months (C × VNS, <italic>n</italic> = 6; VNS × C, <italic>n</italic> = 6). After 6 months of VNS, LVEF and LV end‐systolic volume (ESV) were significantly improved compared with Control (ΔEF Control −4.6 ± 0.9% vs. VNS 6.0 ± 1.6%, <italic>P</italic> < 0.001) and (ΔESV Control 8.3 ± 1.8 mL vs. VNS −3.0 ± 2.3 mL, <italic>P</italic> = 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 (ΔEF Control −2.3 ± 0.65% vs. VNS 6.7 ± 1.1 mL, <italic>P</italic> < 0.001 and ΔESV Control 3.2 ± 1.2 mL vs. VNS −4.0 ± 0.9 mL, <italic>P</italic> < 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%, <italic>P</italic> < 0.001) and ESV (Control 1.5 ± 1.2 mL vs. NS −5.5 ± 1.6 mL, <italic>P</italic> = 0.003) by 6 months.</p> </sec> <sec id="ejhfhft118-1-sec-0003" sec-type="section"> <title>Conclusions</title> <p>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.</p> </sec> </abstract>