Abstract
BackgroundMuscle passive contraction of lower limb by neuromuscular electrostimulation (NMES) is frequently used in chronic heart failure (CHF) patients but no data are available concerning its action on sympathetic activity. However, Transcutaneous Electrical Nerve Stimulation (TENS) is able to improve baroreflex in CHF. The primary aim of the present study was to investigate the acute effect of TENS and NMES compared to Sham stimulation on sympathetic overactivity as assessed by Muscle Sympathetic Nerve Activity (MSNA).MethodsWe performed a serie of two parallel, randomized, double blinded and sham controlled protocols in twenty-two CHF patients in New York Heart Association (NYHA) Class III. Half of them performed stimulation by TENS, and the others tested NMES.ResultsCompare to Sham stimulation, both TENS and NMES are able to reduce MSNA (63.5 ± 3.5 vs 69.7 ± 3.1 bursts / min, p < 0.01 after TENS and 51.6 ± 3.3 vs 56.7 ± 3.3 bursts / min, p < 0, 01 after NMES). No variation of blood pressure, heart rate or respiratory parameters was observed after stimulation.ConclusionThe results suggest that sensory stimulation of lower limbs by electrical device, either TENS or NMES, could inhibit sympathetic outflow directed to legs in CHF patients. These properties could benefits CHF patients and pave the way for a new non-pharmacological approach of CHF.
Highlights
Chronic heart failure (CHF) is characterised by sympathetic overactivity causing direct effect on the initiation and progression of heart failure
100 HB-1, delta of -9.2 ± 2.4 % ) without difference in blood pressure, heart rate and the respiratory parameters. In this double blind, randomized and sham-controlled study, we provide for the first time evidence that Transcutaneous Electrical Nerve Stimulation (TENS) is able to directly reduce sympathetic activity in patients with chronic heart failure (CHF)
We show that this putative beneficial effect linked to a sensory stimulation is preserved while CHF patients are exposed to an electromyostimulation by neuromuscular electrostimulation (NMES), the latter combining sensory and muscular stimulation
Summary
Chronic heart failure (CHF) is characterised by sympathetic overactivity causing direct effect on the initiation and progression of heart failure. In CHF patients, it has been shown recently that cutaneous electrical stimulation improved baroreflex sensitivity [16] and authors hypothesized that TENS could interact with sympathetic activity. The primary aim of the present study was to investigate the acute effect of TENS and NMES compared to Sham stimulation on sympathetic overactivity as assessed by Muscle Sympathetic Nerve Activity (MSNA). Conclusion: The results suggest that sensory stimulation of lower limbs by electrical device, either TENS or NMES, could inhibit sympathetic outflow directed to legs in CHF patients.
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