Key result
Adding vagal nerve stimulation to metoprolol reduces biventricular weight ~10% in heart failure rats.
Why the study?
Does vagal nerve stimulation improve cardiac remodeling and survival in rats with chronic heart failure treated with metoprolol?
Does vagal nerve stimulation improve cardiac remodeling and survival in rats with chronic heart failure treated with metoprolol?
Absolute Event Rate: 2.67% vs 2.96%
p-value: p=<0.05
Vagal nerve stimulation provides additional benefits on cardiac function and survival in heart failure beyond beta-blockade, suggesting mechanisms independent of anti-beta-adrenergic effects.
Supports further investigation of vagal stimulation plus metoprolol in experimental HF; leaves open translation to human outcomes.
Vagal nerve stimulation (VNS) induces bradycardia in chronic heart failure (CHF). We hypothesized that beta-blocker would cover the beneficial effects of VNS on CHF if the anti-beta-adrenergic effect was the main VNS effect. This study investigated the effects of VNS on cardiac remodeling in rats with CHF treated with metoprolol. Two weeks after myocardial infarction, surviving rats were randomly assigned to groups of sham stimulation (SS), sham stimulation with metoprolol (SSM), or VNS with metoprolol (VSM). Compared to the SS group, heart rate was significantly reduced in the SSM and VSM groups. Hemodynamic assessments showed that VSM rats maintained better cardiac pump function and presented higher cardiac index and lower heart weight than SSM rats. VSM was also associated with lower plasma brain natriuretic peptide and norepinephrine levels than SSM. VSM but not SSM improved the 50-day survival rate compared with the SS group. The results suggest that VNS may exert its beneficial effects on the failing heart independently of its anti-beta-adrenergic mechanism.
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Li et al. (2018) studied Chronic heart failure (n=46). Vagal nerve stimulation (VNS) with metoprolol vs. Sham stimulation with metoprolol (SSM) was evaluated on Normalized biventricular weight (g/kg) (p=<0.05). Chronic vagal nerve stimulation combined with metoprolol significantly reduced normalized biventricular weight to 2.67 g/kg compared to 2.96 g/kg with metoprolol alone in rats with chronic heart failure.
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