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      Differential hemodynamic and respiratory responses to right and left cervical vagal nerve stimulation in rats

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          Abstract

          Neuromodulation through vagal nerve stimulation ( VNS) is currently explored for a variety of clinical conditions. However, there are no established VNS parameters for animal models of human diseases, such as hypertension. Therefore, the aim of this study was to assess hemodynamic and respiratory responses to right‐ or left‐sided cervical VNS in a hypertensive rat model. Anesthetized stroke‐prone spontaneously hypertensive rats were instrumented for arterial blood pressure and heart rate monitoring and left‐ or right‐sided VNS. Cervical VNS was applied through bipolar coil electrodes. Stimulation parameters tested were 3 V and 6 V, 2 Hz to 20 Hz stimulation frequency, and 50  μsec to 20 msec pulse duration. Each combination of stimulation parameters was applied twice with altered polarity, that is, anode and cathode in the cranial and caudal position. Respiration rate was derived from systolic blood pressure fluctuations. In general, cervical VNS caused bradycardia, hypotension, and tachypnea. These responses were more pronounced with left‐sided than with right‐sided VNS and depended on the stimulation voltage, stimulation frequency, and pulse duration, but not on the polarity of stimulation. Furthermore, the results suggest that at low stimulation frequencies (<5 Hz) and short pulse durations (<0.5 msec) primarily larger A‐fibers are activated, while at longer pulse durations (>0.5 msec) smaller B‐fibers are also recruited. In conclusion, in rats left‐sided cervical VNS causes greater cardio‐respiratory responses than right‐sided VNS and at lower stimulation frequencies (e.g., 5 Hz), longer pulse durations (>0.5 msec) seem to be required to consistently recruit B‐fibers in addition to A‐fibers.

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          Most cited references21

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          Vagus Nerve Stimulation for the Treatment of Heart Failure: The INOVATE-HF Trial.

          Heart failure (HF) is increasing in prevalence and is a major cause of morbidity and mortality despite advances in medical and device therapy. Autonomic imbalance, with excess sympathetic activation and decreased vagal tone, is an integral component of the pathophysiology of HF.
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            Chronic vagal stimulation for the treatment of low ejection fraction heart failure: results of the NEural Cardiac TherApy foR Heart Failure (NECTAR-HF) randomized controlled trial

            Aim The neural cardiac therapy for heart failure (NECTAR-HF) was a randomized sham-controlled trial designed to evaluate whether a single dose of vagal nerve stimulation (VNS) would attenuate cardiac remodelling, improve cardiac function and increase exercise capacity in symptomatic heart failure patients with severe left ventricular (LV) systolic dysfunction despite guideline recommended medical therapy. Methods Patients were randomized in a 2 : 1 ratio to receive therapy (VNS ON) or control (VNS OFF) for a 6-month period. The primary endpoint was the change in LV end systolic diameter (LVESD) at 6 months for control vs. therapy, with secondary endpoints of other echocardiography measurements, exercise capacity, quality-of-life assessments, 24-h Holter, and circulating biomarkers. Results Of the 96 implanted patients, 87 had paired datasets for the primary endpoint. Change in LVESD from baseline to 6 months was −0.04 ± 0.25 cm in the therapy group compared with −0.08 ± 0.32 cm in the control group (P = 0.60). Additional echocardiographic parameters of LV end diastolic dimension, LV end systolic volume, left ventricular end diastolic volume, LV ejection fraction, peak V02, and N-terminal pro-hormone brain natriuretic peptide failed to show superiority compared to the control group. However, there were statistically significant improvements in quality of life for the Minnesota Living with Heart Failure Questionnaire (P = 0.049), New York Heart Association class (P = 0.032), and the SF-36 Physical Component (P = 0.016) in the therapy group. Conclusion Vagal nerve stimulation as delivered in the NECTAR-HF trial failed to demonstrate a significant effect on primary and secondary endpoint measures of cardiac remodelling and functional capacity in symptomatic heart failure patients, but quality-of-life measures showed significant improvement.
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              The chemical neuroanatomy of vagus nerve stimulation.

              In this short overview a reappraisal of the anatomical connections of vagal afferents is reported. The manuscript moves from classic neuroanatomy to review details of vagus nerve anatomy which are now becoming more and more relevant for clinical outcomes (i.e. the therapeutic use of vagus nerve stimulation). In drawing such an updated odology of central vagal connections the anatomical basis subserving the neurochemical effects of vagal stimulation are addressed. In detail, apart from the thalamic projection of central vagal afferents, the monoaminergic systems appear to play a pivotal role. Stemming from the chemical neuroanatomy of monoamines such as serotonin and norepinephrine the widespread effects of vagal stimulation on cerebral cortical activity are better elucidated. This refers both to the antiepileptic effects and most recently to the beneficial effects of vagal stimulation in mood and cognitive disorders. Copyright © 2010 Elsevier B.V. All rights reserved.
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                Author and article information

                Contributors
                harald-stauss@uiowa.edu
                Journal
                Physiol Rep
                Physiol Rep
                10.1002/(ISSN)2051-817X
                PHY2
                physreports
                Physiological Reports
                John Wiley and Sons Inc. (Hoboken )
                2051-817X
                11 April 2017
                April 2017
                : 5
                : 7 ( doiID: 10.1002/phy2.2017.5.issue-7 )
                : e13244
                Affiliations
                [ 1 ] Department of Health and Human PhysiologyThe University of Iowa Iowa City Iowa
                Author notes
                [*] [* ] Correspondence

                Harald M. Stauss, The University of Iowa, Department of Health and Human Physiology, 410 Field House, Iowa City, IA 52242.

                Tel: 319‐335‐9494

                Fax: 319‐335‐6669

                E‐mail: harald-stauss@ 123456uiowa.edu

                Article
                PHY213244
                10.14814/phy2.13244
                5392529
                28400500
                538af676-7939-47f2-86be-ce897f96e9b0
                © 2017 The Authors. Physiological Reports published by Wiley Periodicals, Inc. on behalf of The Physiological Society and the American Physiological Society.

                This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 09 February 2017
                : 13 March 2017
                : 15 March 2017
                Page count
                Figures: 3, Tables: 3, Pages: 10, Words: 6150
                Funding
                Funded by: University of Iowa Hospitals and Clinics Center for Hypertension Research
                Categories
                Blood Pressure
                Heart
                Control of Breathing
                Autonomic Nervous System
                Original Research
                Original Research
                Custom metadata
                2.0
                phy213244
                April 2017
                Converter:WILEY_ML3GV2_TO_NLMPMC version:5.0.9 mode:remove_FC converted:16.04.2017

                blood pressure,fiber recruitment,heart rate,respiration rate,stimulation parameters

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