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Heart Rate Variability, Microvascular Dysfunction, and Inflammation: Exploring the Potential of taVNS in Managing

Serge C Thal1, Sergey Shityakov2, Ellaine Salvador3

  • 1Department of Anesthesiology, Helios University Hospital, Witten/Herdecke University, 42283 Wuppertal, Germany.

Biomolecules
|April 30, 2025
PubMed

Insights

Type 2 diabetes patients face high heart failure risk. Vagus nerve stimulation may reduce this risk by improving heart rate variability and decreasing inflammation.

Area of Science:

  • Cardiology
  • Endocrinology
  • Neurology

Background:

  • Type 2 diabetes mellitus (T2DM) is a major risk factor for cardiovascular diseases (CVD), with heart failure (HF) being a leading cause of mortality.
  • Despite improved glycemic and cardiovascular risk management, HF prevalence in T2DM patients remains high, suggesting non-glycemic factors contribute significantly.
  • Reduced heart rate variability (HRV) and chronic inflammation are key contributors to HF pathogenesis in T2DM.

Purpose of the Study:

  • To review critical factors influencing CVD risk in T2DM, focusing on HRV and inflammation.
  • To explore the potential of vagus nerve activation, specifically transcutaneous auricular vagus nerve stimulation (taVNS), in mitigating T2DM-related cardiovascular complications.
  • To provide a comprehensive perspective on taVNS for managing HF in T2DM by addressing HRV, microvascular disease, and inflammation.

Main Methods:

  • Literature review examining the interplay of T2DM, CVD, HF, HRV, inflammation, and vagus nerve function.
  • Analysis of current evidence on the role of autonomic dysfunction and systemic inflammation in T2DM-associated HF.
  • Evaluation of transcutaneous auricular vagus nerve stimulation (taVNS) as a therapeutic strategy.

Main Results:

  • Reduced HRV and chronic inflammation are significant drivers of HF in T2DM patients.
  • Vagus nerve activation demonstrates potential in modulating these risk factors and improving cardiovascular outcomes.
  • taVNS emerges as a promising non-invasive intervention to enhance vagal tone and reduce inflammation.

Conclusions:

  • Factors beyond hyperglycemia, including HRV and inflammation, are crucial in T2DM-related HF.
  • taVNS offers a potential therapeutic avenue for managing HF in T2DM by targeting autonomic dysfunction and inflammation.
  • Further research into taVNS is warranted to validate its efficacy in improving cardiovascular outcomes for T2DM patients.

Keywords:
autonomic dysfunctioncardiovascular diseasesheart failureheart rate variabilitymicrovascular complicationssystemic inflammationtranscutaneous auricular vagus nerve stimulationtype 2 diabetes mellitusvagus nerve stimulation

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