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Effects of Low-Level Tragus Stimulation on Endothelial Function in Heart Failure With Reduced Ejection Fraction.

Authors :
Dasari TW
Csipo T
Amil F
Lipecz A
Fulop GA
Jiang Y
Samannan R
Johnston S
Zhao YD
Silva-Palacios F
Stavrakis S
Yabluchanskiy A
Po SS
Source :
Journal of cardiac failure [J Card Fail] 2021 May; Vol. 27 (5), pp. 568-576. Date of Electronic Publication: 2020 Dec 31.
Publication Year :
2021

Abstract

Background: Autonomic dysregulation in heart failure with reduced ejection fraction plays a major role in endothelial dysfunction. Low-level tragus stimulation (LLTS) is a novel, noninvasive method of autonomic modulation.<br />Methods and Results: We enrolled 50 patients with heart failure with reduced ejection fraction (left ventricular ejection fraction of ≤40%) in a randomized, double-blinded, crossover study. On day 1, patients underwent 60 minutes of LLTS with a transcutaneous stimulator (20 Hz, 200 μs pulse width) or sham (ear lobule) stimulation. Macrovascular function was assessed using flow-mediated dilatation in the brachial artery and cutaneous microcirculation with laser speckle contrast imaging in the hand and nail bed. On day 2, patients were crossed over to the other study arm and underwent sham or LLTS; vascular tests were repeated before and after stimulation. Compared with the sham, LLTS improved flow-mediated dilatation by increasing the percent change in the brachial artery diameter (from 5.0 to 7.5, LLTS on day 1, P = .02; and from 4.9 to 7.1, LLTS on day 2, P = .003), compared with no significant change in the sham group (from 4.6 to 4.7, P = .84 on day 1; and from 5.6 to 5.9 on day 2, P = .65). Cutaneous microcirculation in the hand showed no improvement and perfusion of the nail bed showed a trend toward improvement.<br />Conclusions: Our study demonstrated the beneficial effects of acute neuromodulation on macrovascular function. Larger studies to validate these findings and understand mechanistic links are warranted.<br /> (Copyright © 2020 Elsevier Inc. All rights reserved.)

Details

Language :
English
ISSN :
1532-8414
Volume :
27
Issue :
5
Database :
MEDLINE
Journal :
Journal of cardiac failure
Publication Type :
Academic Journal
Accession number :
33387632
Full Text :
https://doi.org/10.1016/j.cardfail.2020.12.017