急性电肌刺激可降低晚期慢性心力衰竭患者的肌肉交感神经活性（EMSICA 研究）。
Acute electromyostimulation decreases muscle sympathetic nerve activity in patients with advanced chronic heart failure (EMSICA Study).
机构信息
National Institute of Health and Medical ResearchTeam 8 Institut des maladies métaboliques et cardiovasculaires, Toulouse, France ; Faculty of Medicine, University of Toulouse III Paul Sabatier F-31432, Toulouse, France ; Federation of Cardiology, Universitary Hospital of Toulouse, F-31073, Toulouse, France ; Physical Medicine and Rehabilitation unit, Universitary Hospital of Toulouse, F-31073, Toulouse, France.
出版信息
PLoS One. 2013 Nov 12;8(11):e79438. doi: 10.1371/journal.pone.0079438. eCollection 2013.
BACKGROUND
Muscle passive contraction of lower limb by neuromuscular electrostimulation (NMES) is frequently used in chronic heart failure (CHF) patients but no data are available concerning its action on sympathetic activity. However, Transcutaneous Electrical Nerve Stimulation (TENS) is able to improve baroreflex in CHF. The primary aim of the present study was to investigate the acute effect of TENS and NMES compared to Sham stimulation on sympathetic overactivity as assessed by Muscle Sympathetic Nerve Activity (MSNA).
METHODS
We performed a serie of two parallel, randomized, double blinded and sham controlled protocols in twenty-two CHF patients in New York Heart Association (NYHA) Class III. Half of them performed stimulation by TENS, and the others tested NMES.
RESULTS
Compare to Sham stimulation, both TENS and NMES are able to reduce MSNA (63.5 ± 3.5 vs 69.7 ± 3.1 bursts / min, p < 0.01 after TENS and 51.6 ± 3.3 vs 56.7 ± 3.3 bursts / min, p < 0, 01 after NMES). No variation of blood pressure, heart rate or respiratory parameters was observed after stimulation.
CONCLUSION
The results suggest that sensory stimulation of lower limbs by electrical device, either TENS or NMES, could inhibit sympathetic outflow directed to legs in CHF patients. These properties could benefits CHF patients and pave the way for a new non-pharmacological approach of CHF.
背景
通过神经肌肉电刺激（NMES）对下肢进行被动肌肉收缩在慢性心力衰竭（CHF）患者中经常使用，但尚无关于其对交感神经活动影响的数据。然而，经皮神经电刺激（TENS）能够改善 CHF 中的压力反射。本研究的主要目的是研究 TENS 和 NMES 与假刺激相比对交感神经过度活动的急性影响，以肌肉交感神经活动（MSNA）评估。
方法
我们在纽约心脏协会（NYHA）III 级的 22 名 CHF 患者中进行了一系列两项平行、随机、双盲和假对照方案。其中一半接受 TENS 刺激，另一半接受 NMES 测试。
结果
与假刺激相比，TENS 和 NMES 均能降低 MSNA（63.5 ± 3.5 与 69.7 ± 3.1 次/分钟，p < 0.01 在 TENS 后和 51.6 ± 3.3 与 56.7 ± 3.3 次/分钟，p < 0.01 在 NMES 后）。刺激后血压、心率或呼吸参数均无变化。
结论
结果表明，通过电设备对下肢进行感觉刺激，无论是 TENS 还是 NMES，都可能抑制 CHF 患者腿部的交感神经输出。这些特性可以使 CHF 患者受益，并为 CHF 的一种新的非药物治疗方法铺平道路。
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