Rehabilitation: Periodic somatosensory stimulation increases arterial baroreflex sensitivity in chronic heart failure patients |
| |
Authors: | Maaike GJ GademanYiping Sun Liming Han Vanessa J ValkMartin J Schalij Henk J van Exel Carolien MHB LucasArie C Maan Harriette F VerweyHedde van de Vooren Gian D PinnaRoberto Maestri Maria Teresa La RovereErnst E van der Wall Cees A Swenne |
| |
Institution: | a Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlandsb Department of Cardiopulmonary Rehabilitation, Rijnland Rehabilitation Center, Leiden, The Netherlandsc Department of Cardiology, Rijnland Hospital, Leiderdorp, The Netherlandsd Department of Biomedical Engineering, S. Maugeri Foundation, IRCCS, Scientific Institute of Montescano, Montescano, Italye Department of Cardiology, S. Maugeri Foundation, IRCCS, Scientific Institute of Montescano, Montescano, Italy |
| |
Abstract: | BackgroundOne of the beneficial effects of exercise training in chronic heart failure (CHF) is an improvement in baroreflex sensitivity (BRS), a prognostic index in CHF. In our hypothesis-generating study we propose that at least part of this effect is mediated by neural afferent information, and more specifically, by exercise-induced somatosensory nerve traffic.ObjectiveTo compare the effects of periodic electrical somatosensory stimulation on BRS in patients with CHF with the effects of exercise training and with usual care.MethodsWe compared in stable CHF patients the effect of transcutaneous electrical nerve stimulation (TENS, N = 23, LVEF 30 ± 9%) with the effects of bicycle exercise training (EXTR, N = 20, LVEF 32 ± 7%). To mimic exercise-associated somatosensory ergoreceptor stimulation, we applied periodic (2/s, marching pace) burst TENS to both feet. TENS and EXTR sessions were held during two successive days.ResultsBRS, measured prior to the first intervention session and one day after the second intervention session, increased by 28% from 3.07 ± 2.06 to 4.24 ± 2.61 ms/mm Hg in the TENS group, but did not change in the EXTR group (baseline: 3.37 ± 2.53 ms/mm Hg; effect: 3.26 ± 2.54 ms/mm Hg) (P(TENS vs EXTR) = 0.02). Heart rate and systolic blood pressure did not change in either group.ConclusionsWe demonstrated that periodic somatosensory input alone is sufficient and efficient in increasing BRS in CHF patients. This concept constitutes a basis for studies towards more effective exercise training regimens in the diseased/impaired, in whom training aimed at BRS improvement should possibly focus more on the somatosensory aspect. |
| |
Keywords: | Chronic heart failure Transcutaneous electrical nerve stimulation Rehabilitation Autonomic nervous system Baroreflex sensitivity |
本文献已被 ScienceDirect 等数据库收录! |
|