The effect of electrical neurostimulation on collateral perfusion during acute coronary occlusion.
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.
de Vries
Jessica
J
Dept of Cardiology, Thoraxcenter, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands. j.de.vries@thorax.umcg.nl
Anthonio
Rutger L
RL
Dejongste
Mike J L
MJ
Jessurun
Gillian A
GA
Tan
Eng-Shiong
ES
de Smet
Bart J G L
BJ
van den Heuvel
Ad F M
AF
Staal
Michiel J
MJ
Zijlstra
Felix
F
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