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慢性正中神经调节可减少心肌梗死后兔模型的室性心律失常并改善心室功能。

Chronic median nerve modulation reduces ventricular arrhythmia and improves ventricular function in a postmyocardial infarction rabbit model.

机构信息

The Cardiac Arrhythmia Center, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Center for Cardiovascular Experimental Study and Evaluation, State Key Laboratory of Cardiovascular Disease, National Clinical Research Center of Cardiovascular Diseases, National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

出版信息

Cardiovasc Ther. 2018 Aug;36(4):e12437. doi: 10.1111/1755-5922.12437. Epub 2018 Jun 28.

Abstract

AIM

Median nerve stimulation (MNS) is a novel neuromodulation approach for treatment of ventricular arrhythmia, but little is known about its chronic effects. The aim of this study was to investigate the effects of chronic MNS on ventricular arrhythmia and ventricular dysfunction postmyocardial infarction (MI).

METHOD

Two weeks after MI, 12 rabbits were randomly divided into control and MNS groups, and chronic MNS was performed in MNS group for 2 weeks. Ventricular function and arrhythmias; sympathetic innervation and activity; and interleukin-1 β (IL-1 β) and norepinephrine (NE) levels were analyzed.

RESULTS

Both the total number of premature ventricular complex and episodes of ventricular tachycardia were lower in MNS group than in control group (20 560 ± 10 314 beats vs 70 079 ± 37 184 beats, P = .021, and 115 ± 63 episodes vs 307 ± 164 episodes, P = .034, respectively). Compared with control group, MNS decreased the cardiac sympathetic nerve density and level of circulating NE in MNS group (1798.42 ± 644.07 μm /mm vs 1003.79 ± 453.00 μm /mm P = .041, and 20.86 ± 4.54 pg/mL vs 11.07 ± 1.43 pg/mL, P = .002, respectively). MNS also improved the left ventricular ejection fraction (59.07 ± 1.91% vs 49.77 ± 3.47%, P = .003) and inhibited the level of IL-1 β in serum (69.19 ± 4.71 pg/mL vs 85.93 ± 12.80 pg/mL, P = .013).

CONCLUSION

Chronic MNS appears to protect against ventricular arrhythmia and improves ventricular function post-MI, which may be mediated by suppressing cardiac sympathetic activity and anti-inflammatory effects.

摘要

目的

正中神经刺激(MNS)是一种治疗室性心律失常的新型神经调节方法,但对其慢性作用知之甚少。本研究旨在探讨慢性 MNS 对心肌梗死后室性心律失常和心室功能的影响。

方法

心肌梗死后 2 周,将 12 只兔子随机分为对照组和 MNS 组,MNS 组行慢性 MNS 2 周。分析心室功能和心律失常;交感神经支配和活性;白细胞介素 1β(IL-1β)和去甲肾上腺素(NE)水平。

结果

与对照组相比,MNS 组室性早搏总数和室性心动过速发作次数均减少(20560±10314 次比 70079±37184 次,P=0.021,115±63 次比 307±164 次,P=0.034)。与对照组相比,MNS 降低了 MNS 组心脏交感神经密度和循环 NE 水平(1798.42±644.07μm/mm 比 1003.79±453.00μm/mm,P=0.041,20.86±4.54pg/mL 比 11.07±1.43pg/mL,P=0.002)。MNS 还改善了左心室射血分数(59.07±1.91%比 49.77±3.47%,P=0.003),并抑制了血清中 IL-1β的水平(69.19±4.71pg/mL 比 85.93±12.80pg/mL,P=0.013)。

结论

慢性 MNS 似乎能预防心肌梗死后室性心律失常,并改善心室功能,这可能是通过抑制心脏交感神经活性和抗炎作用实现的。

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