Garcia Ronald G, Staley Rachel, Aroner Sarah, Stowell Jessica, Sclocco Roberta, Napadow Vitaly, Barbieri Riccardo, Goldstein Jill M
Clinical Neuroscience Laboratory of Sex Differences in the Brain, Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States.
Innovation Center on Sex Differences in Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States.
Front Neurosci. 2022 Dec 9;16:1038339. doi: 10.3389/fnins.2022.1038339. eCollection 2022.
BACKGROUND: The objective of this pilot study was to identify frequency-dependent effects of respiratory-gated auricular vagus afferent nerve stimulation (RAVANS) on the regulation of blood pressure and heart rate variability in hypertensive subjects and examine potential differential effects by sex/gender or race. METHODS: Twenty hypertensive subjects (54.55 ± 6.23 years of age; 12 females and 8 males) were included in a within-person experimental design and underwent five stimulation sessions where they received RAVANS at different frequencies (i.e., 2 Hz, 10 Hz, 25 Hz, 100 Hz, or sham stimulation) in a randomized order. EKG and continuous blood pressure signals were collected during a 10-min baseline, 30-min stimulation, and 10-min post-stimulation periods. Generalized estimating equations (GEE) adjusted for baseline measures were used to evaluate frequency-dependent effects of RAVANS on heart rate, high frequency power, and blood pressure measures, including analyses stratified by sex and race. RESULTS: Administration of RAVANS at 100 Hz had significant overall effects on the reduction of heart rate (β = -2.03, = 0.002). It was also associated with a significant reduction of diastolic (β = -1.90, = 0.01) and mean arterial blood pressure (β = -2.23, = 0.002) in Black hypertensive participants and heart rate in female subjects (β = -2.83, = 0.01) during the post-stimulation period when compared to sham. CONCLUSION: Respiratory-gated auricular vagus afferent nerve stimulation exhibits frequency-dependent rapid effects on the modulation of heart rate and blood pressure in hypertensive patients that may further differ by race and sex. Our findings highlight the need for the development of optimized stimulation protocols that achieve the greatest effects on the modulation of physiological and clinical outcomes in this population.
背景:本初步研究的目的是确定呼吸门控耳迷走神经传入神经刺激(RAVANS)对高血压患者血压调节和心率变异性的频率依赖性影响,并研究性别或种族的潜在差异效应。 方法:20名高血压患者(年龄54.55±6.23岁;12名女性和8名男性)纳入个体内实验设计,进行五次刺激疗程,以随机顺序接受不同频率(即2Hz、10Hz、25Hz、100Hz或假刺激)的RAVANS。在10分钟基线期、30分钟刺激期和10分钟刺激后期收集心电图和连续血压信号。使用针对基线测量进行调整的广义估计方程(GEE)来评估RAVANS对心率、高频功率和血压测量的频率依赖性影响,包括按性别和种族分层的分析。 结果:100Hz的RAVANS给药对心率降低有显著总体效应(β = -2.03,P = 0.002)。与假刺激相比,在刺激后期,它还与黑人高血压参与者的舒张压(β = -1.90,P = 0.01)和平均动脉血压显著降低(β = -2.23,P = 0.002)以及女性受试者的心率降低(β = -2.83,P = 0.01)相关。 结论:呼吸门控耳迷走神经传入神经刺激对高血压患者心率和血压的调节表现出频率依赖性快速效应,且可能因种族和性别而进一步不同。我们的研究结果强调需要制定优化的刺激方案,以对该人群的生理和临床结果调节产生最大影响。
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