Abstract

The anti-inflammatory effects of vagus nerve stimulation are well known. It has recently been shown that low-level, transcutaneous stimulation of vagus nerve at the tragus (LLTS) reduces cardiac inflammation in a rat model of heart failure with preserved ejection fraction (HFpEF). The mechanisms by which LLTS affect the central neural circuits within the brain regions that are important for the regulation of cardiac vagal tone are not clear. Female Dahl salt-sensitive rats were initially fed with either low salt (LS) or high salt (HS) diet for a period of 6 weeks, followed by sham or active stimulation (LLTS) for 30 min daily for 4 weeks. To study the central effects of LLTS, four brainstem (SP5, NAb, NTS, and RVLM) and two forebrain sites (PVN and SFO) were examined. HS diet significantly increased the gene expression of proinflammatory cytokines in the SP5 and SFO. LLTS reversed HS diet-induced changes at both these sites. Furthermore, LLTS augmented the levels of antioxidant Nrf2 in the SP5 and SFO. Taken together, these findings suggest that LLTS has central anti-inflammatory and antioxidant properties that could mediate the neuromodulation of cardiac vagal tone in the rat model of HFpEF.

Highlights

  • The anti-inflammatory effects of vagus nerve stimulation are well known

  • The overall objective of this study was to understand the effects of LLTS on four brainstem (SP5, nucleus ambiguus (NAb), nucleus tractus solitarius (NTS) and rostral ventrolateral medulla (RVLM)) and two forebrain regions (PVN and subfornical organ (SFO)) that are important for the regulation of cardiac vagal ­tone[17] by using a well-established rat model of heart failure with preserved ejection fraction (HFpEF) (Dahl salt sensitive rats)[23]

  • Consistent with our previous study, 4 weeks of LLTS attenuated the increase in blood pressure (BP) (146.0 ± 10.2 mmHg vs. 183.5 ± 9.8 mmHg, respectively, p = 0.04), left ventricular thickness (2.3 ± 0.1 mm vs. 2.7 ± 0.1 mm, p = 0.03, respectively) and diastolic dysfunction (18.8 ± 3.0 vs. 26.5 ± 4.9, p = 0.01, respectively) induced by high salt (HS) diet, without any change in left ventricular ejection fraction (p > 0.05)

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Summary

Introduction

The anti-inflammatory effects of vagus nerve stimulation are well known. It has recently been shown that low-level, transcutaneous stimulation of vagus nerve at the tragus (LLTS) reduces cardiac inflammation in a rat model of heart failure with preserved ejection fraction (HFpEF). Salt sensitive rats on high salt diet as a rodent model for HFpEF, it was recently shown that chronic, intermittent, low-level, tragus stimulation (LLTS) significantly ameliorated diastolic function and attenuated left ventricular (LV) inflammation and ­fibrosis[10]. It is well-established that the auricular branch of the vagus nerve (ABVN) is activated during LLTS, the neural pathways and central mechanisms underlying the effects of LLTS on inflammation and heart function have not been fully ­explored[12]. Whether LLTS acts through any of these neural circuits to exert beneficial effects on the heart is not known

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