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Nonpharmacological Correction of Hypersympatheticotonia in Patients with Chronic Coronary Insufficiency and Severe

Sergey A Afanasiev1, Elena N Pavliukova1, Maria A Kuzmichkina1

  • 1Federal State Budgetary Scientific Institution "Research Institute for Cardiology,", Tomsk, Russia.

Annals of Noninvasive Electrocardiology : the Official Journal of the International Society for Holter and Noninvasive Electrocardiology, Inc
|March 8, 2016
PubMed

Insights

Vagus nerve stimulation (VNS) improved heart failure in coronary artery disease patients by reducing heart rate and enhancing stress proteins. This therapy is most effective in patients with robust endogenous stress-limiting systems.

Area of Science:

  • Cardiology
  • Neurology
  • Immunology

Background:

  • Sympathetic hyperactivity is a key factor in heart failure (HF) among coronary artery disease (CAD) patients.
  • Previous research indicated positive effects of auricular pulsed electrical stimulation of the vagus nerve (VNS) on CAD patients with HF.

Purpose of the Study:

  • To assess the impact of VNS on heart rate (HR) and heat shock protein (HSP) levels in peripheral blood lymphocytes of CAD patients.
  • To evaluate changes in functional status and clinical condition following VNS therapy.

Main Methods:

  • A study involving 70 individuals (aged 50-68) with chronic coronary insufficiency, severe left ventricular dysfunction, and NYHA functional class III-IV HF.
  • The main group (63 patients) received VNS therapy, while a control group (7 patients) underwent sham therapy.
  • Evaluations included the 6-minute walk test, 24-hour ECG monitoring, and immunoenzymatic analysis of HSP70 and HSP60 levels.

Main Results:

  • VNS improved the clinical condition in 58 of 63 patients, decreasing HF functional class and heart rate.
  • In patients with initial HR < 80 bpm, VNS increased HSP70 by 58% and HSP60 by 48% (P < 0.05).
  • Patients with initial HR > 80 bpm showed a significant increase in HSP70, with HSP60 levels remaining unchanged.

Conclusions:

  • VNS effectively corrects autonomous nervous system status, reducing HR and improving cardiac function in CAD patients.
  • The cardiotropic benefits of VNS are most significant in individuals with well-preserved endogenous stress-limiting systems, indicated by HSP60 and/or HSP70 levels.
Abstract

Keywords:
autonomous nervous systemcoronary artery diseaseheart failureheart rate, heat shock proteinsvagus nerve stimulation

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