Effect of epivascular cardiac autonomic nerve stimulation on cardiac function

Mariko Kobayashi, Seiichiro Sakurai, Tohru Takaseya, Akira Shiose, Hyun Il Kim, Masako Fujiki, Jamshid H. Karimov, Raymond Dessoffy, Alex Massiello, Allen G. Borowski, David R. Van Wagoner, Eugene J. Jung, Kiyotaka Fukamachi

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background: The cardiac plexus contains sympathetic and parasympathetic cardiac nerves. Our goal was to assess the hemodynamic and functional effects of stimulating the cardiac autonomic nervous system (CANS) at the epivascular surfaces of the cardiac plexus. Although CANS therapy to modulate cardiovascular function has drawn widespread interest, research has focused only on stimulating parasympathetic or sympathetic nerves, not both at once. Methods: Using general anesthesia and an open-chest surgical procedure, 12 dogs received epivascular stimulation of the cardiac plexus. A bipolar electrode was placed between the right pulmonary artery (PA) and the ascending aorta, with the stimulation frequency/pulse width held constant (20 Hz/4 ms) and the voltage varied (10-50 V). Left ventricular (LV) pressure-volume loops and hemodynamic data were recorded with and without stimulation. Results: In all dogs, aortic and LV systolic pressures, maximum rate of change of LV pressure, and LV stroke work increased (p < 0.0001), as did cardiac output (2.9 ± 1.0-0.4 ± 1.0 L/min; p = 0.001), end-systolic elastance (1.2 ± 0.4-1.5 ± 0.5 mm Hg/mL; p = 0.0001), preload recruitable stroke work (30.1 ± 11.0-39.3 ± 7.8 mm Hg; p = 0.003), and LV ejection fraction (p = 0.012). Systemic vascular resistance increased slightly (p = 0.04), and pulmonary vascular resistance decreased (p = 0.01). Mean heart rate and pulmonary arterial, central venous, and left atrial pressures remained unchanged (p > 0.1). Conclusions: In contrast to inotropic drugs, epivascular CANS stimulation induced a significant and selective increase in LV contractility with no increase in heart rate.

Original languageEnglish
Pages (from-to)1150-1156
Number of pages7
JournalAnnals of Thoracic Surgery
Volume94
Issue number4
DOIs
Publication statusPublished - Oct 1 2012
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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    Kobayashi, M., Sakurai, S., Takaseya, T., Shiose, A., Kim, H. I., Fujiki, M., Karimov, J. H., Dessoffy, R., Massiello, A., Borowski, A. G., Van Wagoner, D. R., Jung, E. J., & Fukamachi, K. (2012). Effect of epivascular cardiac autonomic nerve stimulation on cardiac function. Annals of Thoracic Surgery, 94(4), 1150-1156. https://doi.org/10.1016/j.athoracsur.2012.04.092