Autonomic Neuromodulation Acutely Ameliorates Left Ventricular Strain in Humans.

Author: Tran N1, Asad Z1, Elkholey K1, Scherlag BJ1, Po SS1, Stavrakis S2
Affiliation: <sup>1</sup>University of Oklahoma Health Sciences Center, 800 Stanton L Young Blvd Suite, Oklahoma City, OK, 5400, USA. <sup>2</sup>University of Oklahoma Health Sciences Center, 800 Stanton L Young Blvd Suite, Oklahoma City, OK, 5400, USA. stavros-stavrakis@ouhsc.edu.
Conference/Journal: J Cardiovasc Transl Res.
Date published: 2018 Dec 17
Other: Special Notes: doi: 10.1007/s12265-018-9853-6. [Epub ahead of print] , Word Count: 172


Low-level transcutaneous vagus nerve stimulation at the tragus (LLTS) is anti-adrenergic. We aimed to evaluate the acute effects of LLTS on left ventricular (LV) function and autonomic tone. Patients with diastolic dysfunction and preserved LV ejection fraction were enrolled in a prospective, randomized, double-blind, 2 × 2 cross-over study. Patients received two separate, 1-h sessions, at least 1 day apart, of active LLTS (20 Hz, 1 mA below the discomfort threshold) and sham stimulation. Echocardiography was performed after LLTS or sham stimulation to assess cardiac function. A 5-min ECG was performed to assess heart rate variability (HRV). Twenty-four patients were enrolled. LV global longitudinal strain improved by 1.8 ± 0.9% during active LLTS compared to sham stimulation (p = 0.001). Relative to baseline, HRV frequency domain components (low frequency, high frequency, and their ratio) were favorably altered after LLTS compared to sham stimulation (all p < 0.05). We concluded that LLTS acutely ameliorates cardiac mechanics by modulating the autonomic tone. Trial registration: NCT02983448.

KEYWORDS: Diastolic dysfunction; Heart rate variability; Left ventricular strain imaging; Neuromodulation; Transcutaneous vagus nerve stimulation

PMID: 30560316 DOI: 10.1007/s12265-018-9853-6