Effects of low-level tragus stimulation on endothelial function in heart failure with reduced ejection fraction.

Jan 4, 2021

Contributor: Tarun W Dasari,Tamas Csipo,Faris Amil,Agnes Lipecz,Gabor A Fulop,Yunqiu Jiang,Rajesh Samannan,Sarah Johnston,Yan D Zhao,Federico Silva-Palacios,Stavros Stavrakis,Andriy Yabluchanskiy,Sunny S Po

$Effects of low-level tragus stimulation on endothelial function in heart failure with reduced ejection fraction.$

Autonomic dysregulation in HFrEF plays a major role in endothelial dysfuction. Low level Tragus stimulation (LLTS) is a novel, non-invasive method of autonomic modulation.
We enrolled 50 HFrEF patients (LVEF≤40%) in a randomized, double-blinded, crossover study. Day 1: patients underwent 60 minutes of LLTS with a transcutaneous stimulator (20Hz, 200 μs pulse width) or sham (ear lobule) stimulation. Macrovascular function was assessed using flow mediated dilatation (FMD) in brachial artery and cutaneous microcirculation with laser speckle contrast imaging in hand and nail bed. Day 2: patients were crossed over to other study arm and underwent sham or LLTS; vascular tests were repeated pre- and post-stimulation.
Compared to sham, LLTS improved FMD by increasing the %-change in brachial artery diameter (5 to 7.5, LLTS on day 1, p=0.02; 4.9 to 7.1, LLTS on day 2, p= 0.003), compared to no significant change in the sham group (4.6 to 4.7, p=0.84 on day 1 and 5.6 to 5.9, p=0.65 on day 2). Cutaneous microcirculation in hand showed no improvement and perfusion of nail bed showed a trend towards improvement.
Our study demonstrated beneficial effects of acute neuromodulation on macrovascular function. Larger studies to validate these findings and understand mechanistic links are warranted.

Copyright © 2020. Published by Elsevier Inc.

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About The Expert

Tarun W Dasari

Cardiovascular Section, Department of Internal Medicine, University of Oklahoma Health Sciences Center, OK; Heart Rhythm Institute, University of Oklahoma Health Sciences Center, OK. Electronic address: tarun-dasari@ouhsc.edu.

Tamas Csipo

Department of Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center, OK; Section of Geriatrics, Department of Internal Medicine, University of Oklahoma Health Sciences Center, OK.

Faris Amil

Cardiovascular Section, Department of Internal Medicine, University of Oklahoma Health Sciences Center, OK.

Agnes Lipecz

Department of Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center, OK; Section of Geriatrics, Department of Internal Medicine, University of Oklahoma Health Sciences Center, OK.

Gabor A Fulop

Department of Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center, OK; Section of Geriatrics, Department of Internal Medicine, University of Oklahoma Health Sciences Center, OK.

Yunqiu Jiang

Heart Rhythm Institute, University of Oklahoma Health Sciences Center, OK.

Rajesh Samannan

Cardiovascular Section, Department of Internal Medicine, University of Oklahoma Health Sciences Center, OK.

Sarah Johnston

Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, OK.

Yan D Zhao

Department of Biostatistics and Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, OK.

Federico Silva-Palacios

Cardiovascular Section, Department of Internal Medicine, University of Oklahoma Health Sciences Center, OK.

Stavros Stavrakis

Cardiovascular Section, Department of Internal Medicine, University of Oklahoma Health Sciences Center, OK; Heart Rhythm Institute, University of Oklahoma Health Sciences Center, OK.

Andriy Yabluchanskiy

Department of Biochemistry and Molecular Biology, University of Oklahoma Health Sciences Center, OK; Section of Geriatrics, Department of Internal Medicine, University of Oklahoma Health Sciences Center, OK.

Sunny S Po

Cardiovascular Section, Department of Internal Medicine, University of Oklahoma Health Sciences Center, OK; Heart Rhythm Institute, University of Oklahoma Health Sciences Center, OK.

References

PubMed