title: Acute electromyostimulation decreases muscle sympathetic nerve activity in patients with advanced chronic heart failure (EMSICA Study).
abstract: BACKGROUND
  Muscle 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).
  
  
  METHODS
  We 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.
  
  
  RESULTS
  Compare 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.
  
  
  CONCLUSIONS
  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. These properties could benefits CHF patients and pave the way for a new non-pharmacological approach of CHF.
authors.affiliation: National Institute of Health and Medical ResearchTeam 8 Institut des maladies métaboliques et cardiovasculaires, Toulouse, France ; Faculty of Medicine, University of Toulouse III Paul Sabatier F-31432, Toulouse, France ; Federation of Cardiology, Universitary Hospital of Toulouse, F-31073, Toulouse, France ; Physical Medicine and Rehabilitation unit, Universitary Hospital of Toulouse, F-31073, Toulouse, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Labrunée
authors.forename: Fabien
authors.initials: F
authors.lastname: Despas
authors.forename: Philippe
authors.initials: P
authors.lastname: Marque
authors.forename: Thibaut
authors.initials: T
authors.lastname: Guiraud
authors.forename: Michel
authors.initials: M
authors.lastname: Galinier
authors.forename: Jean Michel
authors.initials: JM
authors.lastname: Senard
authors.forename: Atul
authors.initials: A
authors.lastname: Pathak
mesh_terms: D002908:Chronic Disease; D004599:Electric Stimulation Therapy; D005260:Female; D006333:Heart Failure / Q000503:physiopathology* / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009132:Muscles / Q000294:innervation*; D013564:Sympathetic Nervous System / Q000503:physiopathology*