Myocardial Turnover of Endogenous Opioids and Calcitonin-Gene-Related Peptide in the Human Heart and the Effects of Spinal Cord Stimulation on Pacing-Induced Angina Pectoris

Abstract

Earlier studies have shown that spinal cord stimulation (SCS) has antianginal and anti-ischemic effects in severe coronary artery disease. In the present study, 14 patients were subjected to right-sided atrial catheterization and atrial pacing. The patients were paced to angina during a control session and during spinal cord stimulation. Myocardial extraction of β-endorphin (BE) during control pacing (8 ± 22%) changed to release at the maximum pacing rate during treatment (–21 ± 47%, a negative value representing release). Furthermore, the results indicate local myocardial turnover of leuenkephalin, BE and calcitonin-gene-related peptide. In addition, it is implied that SCS may induce myocardial release of BE which could explain the beneficial effects in myocardial ischemia.

Efficacy and Safety of Percutaneous Transhepatic Portal Embolization before Right Liver Resection Using an Ethibloc/Lipiodol Mixture: A Single-Center Experience

“…Whereas the first publications on portal embolization reported an increase in the residual liver parenchyma volume of 32–127% [29, 30], the more recent literature shows an increase of 13–44% [31, 32]. This variability in the individual series can be explained by different embolic agents, varying preinterventional stages of liver function and varying intervals between portal vein embolization and resection.…”

Cost-Effectiveness of Spinal Cord Stimulation versus Coronary Artery Bypass Grafting in Patients with Severe Angina Pectoris – Long-Term Results from the ESBY Study

“…Earlier studies have indicated that myocardial ischemia is reduced by SCS, which in turn seems to be due to a reduction in oxygen consumption, and that the treatment does not deprive the patient of a warning signal [1, 3, 4, 5, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20]. …”

Electrical Neuromodulation and the Heart with Special Emphasis on Myocardial Ischemia

“…As a result of coffee intake and dipyridamole the metabolic handling adenosine appears to be affected, in the presence of electrical neuromodulation. 108,112 Finally, electrical neuromodulation has been demonstrated both, to release beta-endorphins from the heart 123 and to affect the alpha-receptor. 124 These three prerequisites are all involved in the upregulation of G protein-coupled receptors which, in turn, activate ATP-sensitive K + channels, through up-regulation of protein kinase C. In an experimental set up it was demonstrated that electrical neuromodulation mitigates transient ischemia in anesthetized rabbits.…”