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Article: Remodelling of cardiac sympathetic re-innervation with thoracic spinal cord stimulation improves left ventricular function in a porcine model of heart failure

TitleRemodelling of cardiac sympathetic re-innervation with thoracic spinal cord stimulation improves left ventricular function in a porcine model of heart failure
Authors
KeywordsSympathetic innervation
Spinal cord stimulation
Heart failure
Issue Date2015
Citation
Europace, 2015, v. 17, n. 12, p. 1875-1883 How to Cite?
Abstract© The Author 2015.Aims Thoracic spinal cord stimulation (SCS) has been shown to improve left ventricular ejection fraction (LVEF) in heart failure (HF). Nevertheless, the optimal duration (intermittent vs. continuous) of stimulation and the mechanisms of action remain unclear. Methods and results We performed chronic thoracic SCS at the level of T1-T3 (50 Hz, pulse width 0.2 ms) in 30 adult pigs with HF induced by myocardial infarction and rapid ventricular pacing for 4 weeks. All the animals were treated with daily oral metoprolol succinate (25 mg) plus ramipril (2.5 mg), and randomized to a control group (n = 10), intermittent SCS (4 h ×3, n = 10) or continuous SCS (24 h, n = 10) for 10 weeks. Serial measurements of LVEF and +dP/dt and serum levels of norepinephrine and B-type natriuretic peptide (BNP) were measured. After sacrifice, immunohistological studies of myocardial sympathetic and parasympathetic nerve sprouting and innervation were performed. Echocardiogram revealed a significant increase in LVEF and +dP/dt at 10 weeks in both the intermittent and continuous SCS group compared with controls (P < 0.05). In both SCS groups, there was diffuse sympathetic nerve sprouting over the infarct, peri-infarct, and normal regions compared with only the peri-infarct and infarct regions in the control group. In addition, sympathetic innervation at the peri-infarct and infarct regions was increased following SCS, but decreased in the control group. Myocardium norepinephrine spillover and serum BNP at 10 weeks was significantly decreased only in the continuous SCS group (P < 0.05). Conclusions In a porcine model of HF, SCS induces significant remodelling of cardiac sympathetic innervation over the peri-infarct and infarct regions and is associated with improved LV function and reduced myocardial norepinephrine spillover.
Persistent Identifierhttp://hdl.handle.net/10722/238139
ISSN
2015 Impact Factor: 4.021
2015 SCImago Journal Rankings: 2.201

 

DC FieldValueLanguage
dc.contributor.authorLiao, Song Yan-
dc.contributor.authorLiu, Yuan-
dc.contributor.authorZuo, Mingliang-
dc.contributor.authorZhang, Yuelin-
dc.contributor.authorYue, Wensheng-
dc.contributor.authorAu, Ka Wing-
dc.contributor.authorLai, Wing Hon-
dc.contributor.authorWu, Yangsong-
dc.contributor.authorShuto, Chika-
dc.contributor.authorChen, Peter-
dc.contributor.authorSiu, Chung Wah-
dc.contributor.authorSchwartz, Peter J.-
dc.contributor.authorTse, Hung Fat-
dc.date.accessioned2017-02-03T02:13:10Z-
dc.date.available2017-02-03T02:13:10Z-
dc.date.issued2015-
dc.identifier.citationEuropace, 2015, v. 17, n. 12, p. 1875-1883-
dc.identifier.issn1099-5129-
dc.identifier.urihttp://hdl.handle.net/10722/238139-
dc.description.abstract© The Author 2015.Aims Thoracic spinal cord stimulation (SCS) has been shown to improve left ventricular ejection fraction (LVEF) in heart failure (HF). Nevertheless, the optimal duration (intermittent vs. continuous) of stimulation and the mechanisms of action remain unclear. Methods and results We performed chronic thoracic SCS at the level of T1-T3 (50 Hz, pulse width 0.2 ms) in 30 adult pigs with HF induced by myocardial infarction and rapid ventricular pacing for 4 weeks. All the animals were treated with daily oral metoprolol succinate (25 mg) plus ramipril (2.5 mg), and randomized to a control group (n = 10), intermittent SCS (4 h ×3, n = 10) or continuous SCS (24 h, n = 10) for 10 weeks. Serial measurements of LVEF and +dP/dt and serum levels of norepinephrine and B-type natriuretic peptide (BNP) were measured. After sacrifice, immunohistological studies of myocardial sympathetic and parasympathetic nerve sprouting and innervation were performed. Echocardiogram revealed a significant increase in LVEF and +dP/dt at 10 weeks in both the intermittent and continuous SCS group compared with controls (P < 0.05). In both SCS groups, there was diffuse sympathetic nerve sprouting over the infarct, peri-infarct, and normal regions compared with only the peri-infarct and infarct regions in the control group. In addition, sympathetic innervation at the peri-infarct and infarct regions was increased following SCS, but decreased in the control group. Myocardium norepinephrine spillover and serum BNP at 10 weeks was significantly decreased only in the continuous SCS group (P < 0.05). Conclusions In a porcine model of HF, SCS induces significant remodelling of cardiac sympathetic innervation over the peri-infarct and infarct regions and is associated with improved LV function and reduced myocardial norepinephrine spillover.-
dc.languageeng-
dc.relation.ispartofEuropace-
dc.subjectSympathetic innervation-
dc.subjectSpinal cord stimulation-
dc.subjectHeart failure-
dc.titleRemodelling of cardiac sympathetic re-innervation with thoracic spinal cord stimulation improves left ventricular function in a porcine model of heart failure-
dc.typeArticle-
dc.description.natureLink_to_subscribed_fulltext-
dc.identifier.doi10.1093/europace/euu409-
dc.identifier.scopuseid_2-s2.0-84959079788-
dc.identifier.volume17-
dc.identifier.issue12-
dc.identifier.spage1875-
dc.identifier.epage1883-
dc.identifier.eissn1532-2092-

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