Effects of Low-Level Tragus Stimulation on Endothelial Function in Heart Failure With Reduced Ejection Fraction

Dasari, Tarun W.; Csípő, Tamás; Amil, Faris; Lipécz, Ágnes; Fülöp, Gábor; Jiang, Yunqiu; Samannan, Rajesh; Johnston, Sarah; Zhao, Yan; Silva-Palacios, Federico; Stavrakis, Stavros; Yabluchanskiy, Andriy; Po, Sunny S.

doi:10.1016/j.cardfail.2020.12.017

Cited by 11 publications

(4 citation statements)

References 59 publications

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“…Women responded more strongly to tVNS than men. Women responded more strongly to tVNS than men [216].…”

Section: Discussionmentioning

confidence: 81%

“…To determine the most effective stimulation parameters, Yokota et al [216] examined how tVNS alters ANS activity by comparing the effects of different tVNS frequencies and intensities. In the 35 healthy adult participants, stimulation at an intensity of 3 mA at all frequencies of 100 Hz, 25 Hz, 10 Hz, 1 Hz, and 0 Hz resulted in a significant reduction in heart rate, with stimulation at 100 Hz having the strongest effect.…”

Section: Discussionmentioning

confidence: 99%

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Exploration of transcutaneous vagus nerve stimulation as a treatment option for adjuvant cancer and heart failure therapy

Frank,

Nagai,

Förster

2023

Explor Neuroprot Ther

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Vagus nerve stimulation (VNS) has gained prominence in the treatment of various clinical disorders such as migraine, depression, and tinnitus. Based on increased scientific knowledge of the VNS and insights into the vagus nerve (VN) function and anatomy/conduction, robust treatment approaches have been developed. There are both noninvasive and invasive VNS (iVNS) techniques. Currently, only iVNS techniques are approved by the US Food and Drug Administration (FDA). In contrast, transcutaneous VNS (tVNS) is a new treatment option that is receiving increasing attention. The tVNS application uses the cutaneous distribution of afferent VN fibers in the auricle, the auricular branch of the VN (ABVN), or in the neck, the cervical branch of the VN (CBVN). However, the tVNS technique has not yet been sufficiently researched in its application and mode of action to be used clinically on a large scale. Moreover, the stimulation parameters of the VN vary widely in different studies. Despite the growing number of research papers on this topic, more coherence in neurostimulation research and neuroanatomical basis is needed. The aim of this review is to highlight new clinical treatment options based on existing clinically applied treatment options. In this article, current clinical applications of tVNS are analyzed and important stimulation parameters are highlighted. Based on this data, useful new tVNS therapies are recommended. The focus will be placed on the study of inflammatory processes associated with cancer and on applications to cardiovascular events such as heart failure.

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“…Women responded more strongly to tVNS than men. Women responded more strongly to tVNS than men [216].…”

Section: Discussionmentioning

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Exploration of transcutaneous vagus nerve stimulation as a treatment option for adjuvant cancer and heart failure therapy

Frank,

Nagai,

Förster

2023

Explor Neuroprot Ther

View full text Add to dashboard Cite

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“…More recently, LL-TS has emerged as an intriguing option in patients with chronic HF. LL-TS resulted in a significant improvement in global longitudinal strain, inflammatory cytokines, and quality of life in patients with heart failure with preserved ejection fraction ( 88 , 89 ). The ta-VNS opens an era in the treatment of HF ( Figure 2 ).…”

Section: Evolving Strategymentioning

confidence: 99%

Chronic vagus nerve stimulation in patients with heart failure: challenge or failed translation?

Liao

Liu

et al. 2023

Front. Cardiovasc. Med.

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Autonomic imbalance between the sympathetic and parasympathetic nervous systems contributes to the progression of chronic heart failure (HF). Preclinical studies have demonstrated that various neuromodulation strategies may exert beneficial cardioprotective effects in preclinical models of HF. Based on these encouraging experimental data, vagus nerve stimulation (VNS) has been assessed in patients with HF with a reduced ejection fraction. Nevertheless, the main trials conducted thus far have yielded conflicting findings, questioning the clinical efficacy of VNS in this context. This review will therefore focus on the role of the autonomic nervous system in HF pathophysiology and VNS therapy, highlighting the potential reasons behind the discrepancy between preclinical and clinical studies.

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“…Our study demonstrated the benefi cial effects of acute neuromodulation on macrovascular function. Larger studies to validate these fi ndings and understand mechanistic links are warranted [44].…”

Section: Relative To Therapies In Cardiological Patients and Osteopat...mentioning

confidence: 99%

Heart Failure (HF): Recent innovations in clinical therapy and critical profiles of acute and chronic forms

Perrotta¹

2022

J Cardiovasc Med Cardiol

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Background and objectives: Heart failure is a pathological condition characterized by the inability of the heart to pump (cardiac output) an adequate amount of blood to meet the metabolic needs of the body or, at any rate, to be able to do so only at the expense of increased filling pressures in one or more cardiac chambers and the upstream venous circulation. The research group states here the primary objective of expanding the indications contained in the ESC 2021 with the results of the last year on the subject of treatment profiles, to facilitate a better understanding of the overall clinical picture and contribute to the next edition of the guidelines. Materials and methods: Systematic literature review in the English language from January 1, 2021, to September 30, 2022, on PubMed/MedLine, Web on Science, and Cochrane archive. Our search strategy retrieved 8,317 articles. We excluded books and papers, meta-analyses, reviews, and systematic reviews and selected only 46 studies most significant about the clinical trial and randomized controlled trial. Results: The recent ESC 2021 guidelines are accurate and timely, and have confirmed their usefulness from a functional perspective, including concerning certain aspects that were represented as a “grey area”. Early risk prediction plays a key role in the subsequent management of patients, and to optimize risk prediction and intensity of management, one should take into account that: a) biomarkers have improved the understanding of the pathophysiology of heart failure and may therefore help to adjust the intensity of management in AHF; b) among the wide variety of biomarkers currently available, NT-proBNP and cTn seem the most promising in this indication; c) among the risk scores described, those combining demographic and clinical parameters with biomarkers in a model with routinely available rapid variables seem the most promising tools; d) in addition to biomarkers, age, systolic blood pressure, respiratory rate, oxygen saturation, creatinine, electrolytes, and blood urea nitrogen are the most commonly used predictor variables in the risk scores described; e) among the models selected, the MEESSI-AHF risk score appears to be currently the most promising tool for predicting the risk of AHF; f) during the management of decompensated patients (and in later stages), the psychological aspect is completely ignored, thus promoting the worsening of psychological symptoms (the need is as evident during the acute episode as it is in the daily management of chronic heart failure). Conclusions: The scientific literature search enriched the structure of ESC 2021, suggesting its implementation, with other findings related to new drug therapies such as Sotagliflozin, Hydrochlorothiazide Apabetalone, Alprostadil, Empagliflozin, Sacubitril/Valsartan, Dapagliflozin, Sodium-glucose co-transporter-2 inhibitors, and biomarkers such as Urinary sodium (UNa+), IL-6 levels and rh-brain natriuretic peptide (rhBNP), as well as the use of mindful breathing session, osteopathic manipulative treatment, electrical muscle stimulation, low-level tragus stimulation, venoarterial extracorporeal membrane oxygenation, oral nutritional supplements, and the correlative hypothesis between heart failure and intestinal dysbiosis, also concerning the psychological profile. However, these clinical studies suffer from some limitations that will necessarily have to be taken into account, such as the limited size of the population sample selected or the conflict of interest determined by the fact that some research is funded by the same pharmaceutical company producing the drug used that do not necessarily represent a negative limitation on the results obtained from studies.

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Effects of Low-Level Tragus Stimulation on Endothelial Function in Heart Failure With Reduced Ejection Fraction

Cited by 11 publications

References 59 publications

Exploration of transcutaneous vagus nerve stimulation as a treatment option for adjuvant cancer and heart failure therapy

Exploration of transcutaneous vagus nerve stimulation as a treatment option for adjuvant cancer and heart failure therapy

Chronic vagus nerve stimulation in patients with heart failure: challenge or failed translation?

Heart Failure (HF): Recent innovations in clinical therapy and critical profiles of acute and chronic forms

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