Nonpharmacological Correction of Hypersympatheticotonia in Patients with Chronic Coronary Insufficiency and Severe Left Ventricular Dysfunction

Afanasiev, S. A.; Павлюкова, Е. Н.; Kuzmichkina, M. A.; Rebrova, Т. Yu.; Anfinogenova, Yana; Likhomanov, Konstantin S.; Карпов, Р. С.

doi:10.1111/anec.12349

Cited by 16 publications

(17 citation statements)

References 38 publications

(42 reference statements)

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“…aVNS resulted in an increase of the middle cerebral and supratrochlear artery blood flow velocity in human subjects (Széles and Litscher, 2004 ) and a decrease of the velocity of the carotid-femoral flow (Hackl et al, 2017 ). aVNS diminishes systolic blood pressure in subjects with coronary artery diseases as well as in subjects with dysfunctions of glucose metabolism (Zamotrinsky et al, 2001 ; Huang et al, 2014 ; Stavrakis et al, 2015 ) it suppresses atrial fibrillation in patients with paroxysmal atrial fibrillation (Afanasiev et al, 2016 ) and reliefs anginal symptoms in coronary artery disease patients (Zamotrinsky et al, 1997 ). aVNS improves cardiac baroreflex sensitivity (Antonino et al, 2017 ), increases capillary-venous oxygenation in deep tissues in diabetic patients (Kaniusas et al, 2015 ), increases skin temperature in human subjects with disfunctions of the peripheral arteries and chronic diabetic wounds (Szeles et al, 2013 ) and improves symptoms in peripheral arterial occlusive diseases (Payrits et al, 2011 ).…”

Section: Resultsmentioning

confidence: 99%

Non-invasive Auricular Vagus Nerve Stimulation as a Potential Treatment for Covid19-Originated Acute Respiratory Distress Syndrome

Kaniušas

Széles

Kampusch³

et al. 2020

Front. Physiol.

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Background: Covid-19 is an infectious disease caused by an invasion of the alveolar epithelial cells by coronavirus 19. The most severe outcome of the disease is the Acute Respiratory Distress Syndrome (ARDS) combined with hypoxemia and cardiovascular damage. ARDS and co-morbidities are associated with inflammatory cytokine storms, sympathetic hyperactivity, and respiratory dysfunction. Hypothesis: In the present paper, we present and justify a novel potential treatment for Covid19-originated ARDS and associated co-morbidities, based on the non-invasive stimulation of the auricular branch of the vagus nerve. Methods: Auricular vagus nerve stimulation activates the parasympathetic system including anti-inflammatory pathways (the cholinergic anti-inflammatory pathway and the hypothalamic pituitary adrenal axis) while regulating the abnormal sympatho-vagal balance and improving respiratory control. Results: Along the paper (1) we expose the role of the parasympathetic system and the vagus nerve in the control of inflammatory processes (2) we formulate our physiological and methodological hypotheses (3) we provide a large body of clinical and preclinical data that support the favorable effects of auricular vagus nerve stimulation in inflammation, sympatho-vagal balance as well as in respiratory and cardiac ailments, and (4) we list the (few) possible collateral effects of the treatment. Finally, we discuss auricular vagus nerve stimulation protective potential, especially in the elderly and co-morbid population with already reduced parasympathetic response. Conclusions: Auricular vagus nerve stimulation is a safe clinical procedure and it could be either an effective treatment for ARDS originated by Covid-19 and similar viruses or a supplementary treatment to actual ARDS therapeutic approaches.

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Section: Resultsmentioning

confidence: 99%

Non-invasive Auricular Vagus Nerve Stimulation as a Potential Treatment for Covid19-Originated Acute Respiratory Distress Syndrome

Kaniušas

Széles

Kampusch³

et al. 2020

Front. Physiol.

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“…In addition tVNS was shown to have a bradycardiac effect in these patients along with increased levels of heat shock proteins HSP60 and HSP70 in patients who had an initial heart rate of less than 80 bpm. Patients with a heart rate greater than 80 bpm exhibited increased the levels of HSP70 alone (Afanasiev et al, 2016). Cardiovascular disorders therefore appear to be a suitable target for treatment with tVNS (see also supplementary Table 1).…”

Section: Cardiac Effects Of Tvnsmentioning

confidence: 99%

The strange case of the ear and the heart: The auricular vagus nerve and its influence on cardiac control

Murray

Atkinson

Mahadi

et al. 2016

Autonomic Neuroscience

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The human ear seems an unlikely candidate for therapies aimed at improving cardiac function, but the ear and the heart share a common connection: the vagus nerve. In recent years there has been increasing interest in the auricular branch of the vagus nerve (ABVN), a unique cutaneous subdivision of the vagus distributed to the external ear. Non-invasive electrical stimulation of this nerve through the skin may offer a simple, cost-effective alternative to the established method of vagus nerve stimulation (VNS), which requires a surgical procedure and has generated mixed results in a number of clinical trials for heart failure. This review discusses the available evidence in support of modulating cardiac activity using this strange auricular nerve.

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“…Auricular vagus nerve stimulation (VNS) is a new neuromodulatory technique for the treatment of, for instance, epilepsy (Bauer et al, 2016), chronic low back pain (Sator-Katzenschlager et al, 2004), and psychiatric disorders like autism (Cimpianu et al, 2017). Moreover, the auricular VNS has some effects on cardiovascular system like suppressing atrial fibrillation (Stavrakis et al, 2015) and improving cardiac function in patients with coronary artery disease (Afanasiev et al, 2016), as summarized in our recent reviews (Kaniusas et al, 2019a,b).…”

Section: Introductionmentioning

confidence: 99%

High-Resolution Episcopic Imaging for Visualization of Dermal Arteries and Nerves of the Auricular Cymba Conchae in Humans

et al. 2020

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Therapeutic applications of auricular vagus nerve stimulation (VNS) have drawn recent attention. Since the targeted stimulation process and parameters depend on the electrode-tissue interaction, the lack of structural anatomical information on innervation and vascularization of the auricle restrain the current optimization of stimulation paradigms. For the first time, we employed high-resolution episcopic imaging (HREM) to generate histologic volume data from donated human cadaver ears. Optimal parameters for specimen preparation were evaluated. Anatomical 3D vascular and nerve structures were reconstructed in one sample of an auricular cymba conchae (CC). The feasibility of HREM to visualize anatomical structures was assessed in that diameters, occupied areas, volumes, and mutual distances between auricular arteries, nerves, and veins were registered. The selected region of CC (3 × 5.5 mm) showed in its cross-sections 21.7 ± 2.7 (mean ± standard deviation) arteries and 14.66 ± 2.74 nerve fibers. Identified nerve diameters were 33.66 ± 21.71 µm, and arteries had diameters in the range of 71.58 ± 80.70 µm. The respective occupied area showed a share of, on average, 2.71% and 0.3% for arteries and nerves, respectively, and similar volume occupancy for arteries and nerves. Inter-centroid minimum distance between arteries and nerves was 274 ± 222 µm. The density of vessels and nerves around a point within CC on a given grid was assessed, showing that 50% of all vessels and nerves were found in a radial distance of 1.6-1.8 mm from any of these points, which is strategically relevant when using stimulation needles in the auricle for excitation of nerves. HREM seems suitable for anatomical studies of the human ear. A 3D model of CC was established in the micrometer scale, which forms the basis for future optimization of the auricular VNS. Obviously, the presented single cadaver study needs to be validated by additional anatomical data on the innervation and vascularization of the auricle.

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Nonpharmacological Correction of Hypersympatheticotonia in Patients with Chronic Coronary Insufficiency and Severe Left Ventricular Dysfunction

Abstract: Correction of autonomous nervous status by VNS attenuated HR and improved functional state of the heart in CAD patients. Cardiotropic effect of VNS was the most pronounced in patients with preserved endogenous stress-limiting systems associated with hsp60 and/or hsp70.

Cited by 16 publications

References 38 publications

Non-invasive Auricular Vagus Nerve Stimulation as a Potential Treatment for Covid19-Originated Acute Respiratory Distress Syndrome

Non-invasive Auricular Vagus Nerve Stimulation as a Potential Treatment for Covid19-Originated Acute Respiratory Distress Syndrome

The strange case of the ear and the heart: The auricular vagus nerve and its influence on cardiac control

High-Resolution Episcopic Imaging for Visualization of Dermal Arteries and Nerves of the Auricular Cymba Conchae in Humans

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