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Article: Thoracic spinal cord stimulation improves cardiac contractile function and myocardial oxygen consumption in a porcine model of ischemic heart failure
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TitleThoracic spinal cord stimulation improves cardiac contractile function and myocardial oxygen consumption in a porcine model of ischemic heart failure
 
AuthorsLiu, Y2
Yue, WS2
Liao, SY2
Zhang, Y2
Au, KW2
Shuto, C3
Hata, C3
Park, E3
Chen, P3
Siu, CW2 1
Tse, HF2 1
 
KeywordsHeart Failure
Ischemic Cardiomyopathy
Myocardial Infarction
Pacing
Spinal Cord Stimulation
 
Issue Date2012
 
PublisherWiley-Blackwell Publishing, Inc.. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=1045-3873
 
CitationJournal Of Cardiovascular Electrophysiology, 2012, v. 23 n. 5, p. 534-540 [How to Cite?]
DOI: http://dx.doi.org/10.1111/j.1540-8167.2011.02230.x
 
AbstractThoracic Spinal Cord Stimulation. Background: Prior experimental studies show that thoracic spinal cord stimulation (SCS) improves left ventricular (LV) ejection fraction (LVEF). The mechanism of this improvement in the LV contractile function after SCS and its effects on the myocardial oxygen consumption remains unknown. Methods and Results: We performed thoracic SCS (T1-T2 level) followed by 4 weeks of rapid ventricular pacing in 9 adult pigs with ischemic heart failure (HF) induced by myocardial infarction (MI). At 24 hours off-pacing, detailed echocardiogram and invasive hemodynamic assessment were performed to determine LV contractile function and myocardial oxygen consumption. Serum norepinephrine level was measured before and after SCS. SCS was performed on 2 occasions for 15 minutes, 30 minutes apart (recovery) with 50 Hz frequency (pulse width 0.2 millisecond, 90% of motor threshold at 2 Hz output). Echocardiogram revealed significant decrease in LVEF (33.8 ± 1.8% vs 66.5 ± 1.7%, P < 0.01) after induction of MI and HF. Compared with MI and HF, acute SCS significantly increased LVEF and +dP/dt (all P < 0.05). Withdrawal of SCS during recovery decreased +dP/dt, but not LVEF that increased again with repeated SCS. Myocardial oxygen consumption also significantly decreased during SCS compared with MI and HF (P = 0.006) without any change in serum norepinephrine level (P = 0.9). Speckle tracking imaging showed significant improvement in global and regional circumferential strains over the infarcted mid and apical regions, decreased in time to peak circumferential strain over the lateral and posterior wall after SCS, and the degree of intraventricular dyssynchrony during SCS compared with MI and HF (P < 0.05). Conclusions: In a porcine model of ischemic HF, acute SCS improved global and regional LV contractile function and intraventricular dyssynchrony, and decreased myocardial oxygen consumption without elevation of norepinephrine level. © 2011 Wiley Periodicals, Inc.
 
ISSN1045-3873
2013 Impact Factor: 2.881
 
DOIhttp://dx.doi.org/10.1111/j.1540-8167.2011.02230.x
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorLiu, Y
 
dc.contributor.authorYue, WS
 
dc.contributor.authorLiao, SY
 
dc.contributor.authorZhang, Y
 
dc.contributor.authorAu, KW
 
dc.contributor.authorShuto, C
 
dc.contributor.authorHata, C
 
dc.contributor.authorPark, E
 
dc.contributor.authorChen, P
 
dc.contributor.authorSiu, CW
 
dc.contributor.authorTse, HF
 
dc.date.accessioned2012-09-05T05:32:06Z
 
dc.date.available2012-09-05T05:32:06Z
 
dc.date.issued2012
 
dc.description.abstractThoracic Spinal Cord Stimulation. Background: Prior experimental studies show that thoracic spinal cord stimulation (SCS) improves left ventricular (LV) ejection fraction (LVEF). The mechanism of this improvement in the LV contractile function after SCS and its effects on the myocardial oxygen consumption remains unknown. Methods and Results: We performed thoracic SCS (T1-T2 level) followed by 4 weeks of rapid ventricular pacing in 9 adult pigs with ischemic heart failure (HF) induced by myocardial infarction (MI). At 24 hours off-pacing, detailed echocardiogram and invasive hemodynamic assessment were performed to determine LV contractile function and myocardial oxygen consumption. Serum norepinephrine level was measured before and after SCS. SCS was performed on 2 occasions for 15 minutes, 30 minutes apart (recovery) with 50 Hz frequency (pulse width 0.2 millisecond, 90% of motor threshold at 2 Hz output). Echocardiogram revealed significant decrease in LVEF (33.8 ± 1.8% vs 66.5 ± 1.7%, P < 0.01) after induction of MI and HF. Compared with MI and HF, acute SCS significantly increased LVEF and +dP/dt (all P < 0.05). Withdrawal of SCS during recovery decreased +dP/dt, but not LVEF that increased again with repeated SCS. Myocardial oxygen consumption also significantly decreased during SCS compared with MI and HF (P = 0.006) without any change in serum norepinephrine level (P = 0.9). Speckle tracking imaging showed significant improvement in global and regional circumferential strains over the infarcted mid and apical regions, decreased in time to peak circumferential strain over the lateral and posterior wall after SCS, and the degree of intraventricular dyssynchrony during SCS compared with MI and HF (P < 0.05). Conclusions: In a porcine model of ischemic HF, acute SCS improved global and regional LV contractile function and intraventricular dyssynchrony, and decreased myocardial oxygen consumption without elevation of norepinephrine level. © 2011 Wiley Periodicals, Inc.
 
dc.description.naturelink_to_subscribed_fulltext
 
dc.identifier.citationJournal Of Cardiovascular Electrophysiology, 2012, v. 23 n. 5, p. 534-540 [How to Cite?]
DOI: http://dx.doi.org/10.1111/j.1540-8167.2011.02230.x
 
dc.identifier.doihttp://dx.doi.org/10.1111/j.1540-8167.2011.02230.x
 
dc.identifier.epage540
 
dc.identifier.hkuros205027
 
dc.identifier.issn1045-3873
2013 Impact Factor: 2.881
 
dc.identifier.issue5
 
dc.identifier.pmid22151312
 
dc.identifier.scopuseid_2-s2.0-84860840461
 
dc.identifier.spage534
 
dc.identifier.urihttp://hdl.handle.net/10722/163489
 
dc.identifier.volume23
 
dc.languageeng
 
dc.publisherWiley-Blackwell Publishing, Inc.. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=1045-3873
 
dc.publisher.placeUnited States
 
dc.relation.ispartofJournal of Cardiovascular Electrophysiology
 
dc.relation.referencesReferences in Scopus
 
dc.subjectHeart Failure
 
dc.subjectIschemic Cardiomyopathy
 
dc.subjectMyocardial Infarction
 
dc.subjectPacing
 
dc.subjectSpinal Cord Stimulation
 
dc.titleThoracic spinal cord stimulation improves cardiac contractile function and myocardial oxygen consumption in a porcine model of ischemic heart failure
 
dc.typeArticle
 
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<contributor.author>Zhang, Y</contributor.author>
<contributor.author>Au, KW</contributor.author>
<contributor.author>Shuto, C</contributor.author>
<contributor.author>Hata, C</contributor.author>
<contributor.author>Park, E</contributor.author>
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<contributor.author>Siu, CW</contributor.author>
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<description.abstract>Thoracic Spinal Cord Stimulation. Background: Prior experimental studies show that thoracic spinal cord stimulation (SCS) improves left ventricular (LV) ejection fraction (LVEF). The mechanism of this improvement in the LV contractile function after SCS and its effects on the myocardial oxygen consumption remains unknown. Methods and Results: We performed thoracic SCS (T1-T2 level) followed by 4 weeks of rapid ventricular pacing in 9 adult pigs with ischemic heart failure (HF) induced by myocardial infarction (MI). At 24 hours off-pacing, detailed echocardiogram and invasive hemodynamic assessment were performed to determine LV contractile function and myocardial oxygen consumption. Serum norepinephrine level was measured before and after SCS. SCS was performed on 2 occasions for 15 minutes, 30 minutes apart (recovery) with 50 Hz frequency (pulse width 0.2 millisecond, 90% of motor threshold at 2 Hz output). Echocardiogram revealed significant decrease in LVEF (33.8 &#177; 1.8% vs 66.5 &#177; 1.7%, P &lt; 0.01) after induction of MI and HF. Compared with MI and HF, acute SCS significantly increased LVEF and +dP/dt (all P &lt; 0.05). Withdrawal of SCS during recovery decreased +dP/dt, but not LVEF that increased again with repeated SCS. Myocardial oxygen consumption also significantly decreased during SCS compared with MI and HF (P = 0.006) without any change in serum norepinephrine level (P = 0.9). Speckle tracking imaging showed significant improvement in global and regional circumferential strains over the infarcted mid and apical regions, decreased in time to peak circumferential strain over the lateral and posterior wall after SCS, and the degree of intraventricular dyssynchrony during SCS compared with MI and HF (P &lt; 0.05). Conclusions: In a porcine model of ischemic HF, acute SCS improved global and regional LV contractile function and intraventricular dyssynchrony, and decreased myocardial oxygen consumption without elevation of norepinephrine level. &#169; 2011 Wiley Periodicals, Inc.</description.abstract>
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Author Affiliations
  1. The University of Hong Kong Li Ka Shing Faculty of Medicine
  2. The University of Hong Kong
  3. St. Jude Medical, Inc. USA