Inflammatory cytokines and nitric oxide in heart failure and potential modulation by vagus nerve stimulation.
In heart failure, an inflammatory response may occur. The relationship between inflammatory cytokines, NOS and heart failure progression remains uncertain. Parasympathetic activation can affect heart rate and AV conduction. In heart failure, a relationship between the vagus nerve and the inflammatory response has been proposed. Vagal nerve stimulation can modulate the inflammatory response and affect specific inflammatory mediators including nitric oxide that may be contributory to continued or progressive heart failure. Therefore, vagal nerve stimulation may have beneficial effects that are independent from heart rate or AV conduction in heart failure. Challenges remain regarding the relationship between specific inflammatory markers and heart failure and how to best modulate the cytokines and NOS in patients to achieve beneficial effects. Future studies need to evaluate whether modulating inflammatory cytokines and NOS via vagal nerve stimulation can improve cardiac performance and outcomes in patients with heart failure.
Li
Weiwei
W
Cardiac Electrophysiology, University of Iowa Hospitals, 200 Hawkins Drive, Room 4426a JCP, Iowa City, IA 52242, USA.
Olshansky
Brian
B
D001283:Atrioventricular Node; D016207:Cytokines / Q000378:metabolism*; D018450:Disease Progression; D006333:Heart Failure / Q000378:metabolism / Q000503:physiopathology* / Q000628:therapy; D006339:Heart Rate; D006801:Humans; D007155:Immunologic Factors; D007249:Inflammation / Q000378:metabolism* / Q000473:pathology; D009569:Nitric Oxide / Q000378:metabolism*; D019001:Nitric Oxide Synthase / Q000378:metabolism; D010275:Parasympathetic Nervous System; D014630:Vagus Nerve / Q000473:pathology*; D055536:Vagus Nerve Stimulation
D016207:Cytokines; D007155:Immunologic Factors; D009569:Nitric Oxide; D019001:Nitric Oxide Synthase