Department of Anesthesiology, University of California Los Angeles, CA, United States.
Division of Cardiac Surgery, University of California Los Angeles, CA, United States.
Auton Neurosci. 2018 Sep;213:15-22. doi: 10.1016/j.autneu.2018.05.005. Epub 2018 May 12.
Augmentation of cardiac sympathetic tone has been shown to induce ventricular arrhythmias. Acupuncture has been clinically used to treat hypertension, angina pectoris, and atrial arrhythmias. However, the effects of acupuncture on ventricular electrophysiology and autonomic tone remain unknown. We hypothesized that acupuncture attenuates cardiac excitability and corrects the imbalance of autonomic tone during sympathetic hyperactivity. Fourteen Yorkshire pigs were randomized to electroacupuncture (EA, 2 Hz, 0.3-0.5 mA, 0.5 ms duration) or control (without EA) groups. Animals were sedated with terazol. General anesthesia consisted of isoflurane and fentanyl during surgical preparation and was transitioned to α-chloralose during experimental protocols. Through a median sternotomy, the heart was exposed and fitted with an elastic epicardial 56-electrode sock. Cardiac excitability was measured via activation recovery interval (ARI) and dispersion of repolarization (DOR) while autonomic balance was evaluated by heart rate variability (HRV) power spectrum analysis at baseline and during left stellate ganglion stimulation (LSS) with and without EA delivered at P 5-6 acupoints. 30-min of EA did not alter the baseline ARI and DOR, but significantly suppressed cardiac excitability during LSS through attenuation of ARI shortening (EA 2.1 ± 0.3% vs. control 5.2 ± 0.7%, P < 0.05) and DOR (EA 74.3 ± 26.9% vs., control 110.1 ± 22.9%, P < 0.05). EA significantly attenuated the increase in LF/HF (EA 0.6 ± 0.1 vs. control 1.1 ± 0.2, P < 0.05). In conclusion, EA reduces the cardiac excitability induced by LSS through correction of cardiac sympathovagal balance. This study provides mechanistic insights underlying cardiac neuromodulation of EA during sympathoexcitation.
心脏交感神经张力的增强已被证明会引起室性心律失常。针灸已在临床上用于治疗高血压、心绞痛和心房颤动。然而,针灸对心室电生理和自主神经张力的影响尚不清楚。我们假设针灸可以减弱心脏兴奋性,并在交感神经兴奋时纠正自主神经平衡的失衡。14 头约克夏猪随机分为电针(EA,2 Hz,0.3-0.5 mA,0.5 ms 持续时间)或对照(无 EA)组。动物用替扎唑镇静。全身麻醉在手术准备期间使用异氟烷和芬太尼,并在实验方案中过渡到α-氯醛。通过正中胸骨切开术暴露心脏,并安装弹性心外膜 56 电极袜。通过激活恢复间隔(ARI)和复极离散度(DOR)测量心脏兴奋性,同时通过心率变异性(HRV)功率谱分析评估自主平衡,在基线和左星状神经节刺激(LSS)期间评估自主平衡,同时有无 EA 在心电 5-6 点。30 分钟的 EA 并未改变基线 ARI 和 DOR,但通过抑制 ARI 缩短(EA 2.1±0.3%对控制 5.2±0.7%,P<0.05)和 DOR(EA 74.3±26.9%对控制 110.1±22.9%,P<0.05),在 LSS 期间显著抑制了心脏兴奋性。EA 显著减弱 LF/HF 的增加(EA 0.6±0.1 对控制 1.1±0.2,P<0.05)。总之,EA 通过纠正心脏交感神经平衡,降低了由 LSS 引起的心脏兴奋性。这项研究为交感兴奋时 EA 对心脏的神经调节提供了机制上的见解。