title: The effect of electrical neurostimulation on collateral perfusion during acute coronary occlusion.
abstract: BACKGROUND
  Electrical neurostimulation can be used to treat patients with refractory angina, it reduces angina and ischemia. Previous data have suggested that electrical neurostimulation may alleviate myocardial ischaemia through increased collateral perfusion. We investigated the effect of electrical neurostimulation on functional collateral perfusion, assessed by distal coronary pressure measurement during acute coronary occlusion. We sought to study the effect of electrical neurostimulation on collateral perfusion.
  
  
  METHODS
  Sixty patients with stable angina and significant coronary artery disease planned for elective percutaneous coronary intervention were split in two groups. In all patients two balloon inflations of 60 seconds were performed, the first for balloon dilatation of the lesion (first episode), the second for stent delivery (second episode). The Pw/Pa ratio (wedge pressure/aortic pressure) was measured during both ischaemic episodes. Group 1 received 5 minutes of active neurostimulation before plus 1 minute during the first episode, group 2 received 5 minutes of active neurostimulation before plus 1 minute during the second episode.
  
  
  RESULTS
  In group 1 the Pw/Pa ratio decreased by 10 +/- 22% from 0.20 +/- 0.09 to 0.19 +/- 0.09 (p = 0.004) when electrical neurostimulation was deactivated. In group 2 the Pw/Pa ratio increased by 9 +/- 15% from 0.22 +/- 0.09 to 0.24 +/- 0.10 (p = 0.001) when electrical neurostimulation was activated.
  
  
  CONCLUSIONS
  Electrical neurostimulation induces a significant improvement in the Pw/Pa ratio during acute coronary occlusion.
authors.affiliation: Dept of Cardiology, Thoraxcenter, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands. j.de.vries@thorax.umcg.nl
authors.forename: Jessica
authors.initials: J
authors.lastname: de Vries
authors.forename: Rutger L
authors.initials: RL
authors.lastname: Anthonio
authors.forename: Mike J L
authors.initials: MJ
authors.lastname: Dejongste
authors.forename: Gillian A
authors.initials: GA
authors.lastname: Jessurun
authors.forename: Eng-Shiong
authors.initials: ES
authors.lastname: Tan
authors.forename: Bart J G L
authors.initials: BJ
authors.lastname: de Smet
authors.forename: Ad F M
authors.initials: AF
authors.lastname: van den Heuvel
authors.forename: Michiel J
authors.initials: MJ
authors.lastname: Staal
authors.forename: Felix
authors.initials: F
authors.lastname: Zijlstra
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D001011:Aorta / Q000503:physiopathology; D021721:Balloon Occlusion; D001794:Blood Pressure; D003097:Collateral Circulation; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications* / Q000503:physiopathology / Q000628:therapy; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D011669:Pulmonary Wedge Pressure; D012107:Research Design; D012720:Severity of Illness Index; D015607:Stents; D004561:Transcutaneous Electric Nerve Stimulation; D016896:Treatment Outcome