title: Nonpharmacological Correction of Hypersympatheticotonia in Patients with Chronic Coronary Insufficiency and Severe Left Ventricular Dysfunction.
abstract: BACKGROUND
  Control of sympathetic hyperactivity is pivotal for treatment of heart failure (HF) in patients with coronary artery disease (CAD). Our earlier studies demonstrated that the auricular pulsed electrical stimulation of the vagus nerve (VNS) beneficially affected condition of CAD patients with HF. The aim of our study was to evaluate changes in heart rate (HR) and the levels of heat shock proteins in peripheral blood lymphocytes in patients with CAD in the course of VNS.
  
  
  METHODS
  The study comprised 70 individuals aged 50-68 years with chronic coronary insufficiency, severe left ventricular dysfunction, and NYHA functional class (FC) III-IV HF. Main group included 63 patients who received VNS course (group 1). Control patients (n = 7) received sham therapy (group 2).
  
  
  RESULTS
  According to the results of 6-minute walk test and 24-hour ECG monitoring, administration of VNS improved clinical condition of 58 of 63 patients, decreased HF FC, and attenuated HR. Clinical condition in sham therapy group did not change. Immunoenzyme method demonstrated that hsp70 and hsp60 contents in peripheral blood lymphocyte lysate increased by 58% and 48% (P < 0.05), respectively, in patients who initially had HR < 80 bpm. The hsp70 level significantly increased and hsp60 level remained unchanged in patients with initial HR > 80 bpm.
  
  
  CONCLUSIONS
  Correction of autonomous nervous status by VNS attenuated HR and improved functional state of the heart in CAD patients. Cardiotropic effect of VNS was the most pronounced in patients with preserved endogenous stress-limiting systems associated with hsp60 and/or hsp70.
authors.affiliation: Federal State Budgetary Scientific Institution "Research Institute for Cardiology,", Tomsk, Russia.
authors.forename: Sergey A
authors.initials: SA
authors.lastname: Afanasiev
authors.affiliation: Federal State Budgetary Scientific Institution "Research Institute for Cardiology,", Tomsk, Russia.
authors.forename: Elena N
authors.initials: EN
authors.lastname: Pavliukova
authors.affiliation: Federal State Budgetary Scientific Institution "Research Institute for Cardiology,", Tomsk, Russia.
authors.forename: Maria A
authors.initials: MA
authors.lastname: Kuzmichkina
authors.affiliation: Federal State Budgetary Scientific Institution "Research Institute for Cardiology,", Tomsk, Russia.
authors.forename: Tatiana Yu
authors.initials: TY
authors.lastname: Rebrova
authors.affiliation: Federal State Budgetary Scientific Institution "Research Institute for Cardiology,", Tomsk, Russia. anfy@tpu.ru.|National Research Tomsk Polytechnic University, Institute of Physics and Technology, Tomsk, Russia. anfy@tpu.ru.
authors.forename: Yana
authors.initials: Y
authors.lastname: Anfinogenova
authors.affiliation: Federal State Budgetary Scientific Institution "Research Institute for Cardiology,", Tomsk, Russia.
authors.forename: Konstantin S
authors.initials: KS
authors.lastname: Likhomanov
authors.affiliation: Federal State Budgetary Scientific Institution "Research Institute for Cardiology,", Tomsk, Russia.
authors.forename: Rostislav S
authors.initials: RS
authors.lastname: Karpov
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D003324:Coronary Artery Disease / Q000503:physiopathology* / Q000628:therapy*; D004599:Electric Stimulation Therapy; D004562:Electrocardiography; D005080:Exercise Test; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006360:Heat-Shock Proteins / Q000097:blood; D006801:Humans; D008297:Male; D008875:Middle Aged; D013564:Sympathetic Nervous System / Q000503:physiopathology*; D014630:Vagus Nerve / Q000503:physiopathology; D018487:Ventricular Dysfunction, Left / Q000503:physiopathology* / Q000628:therapy*
chemical_list: D015415:Biomarkers; D006360:Heat-Shock Proteins
keywords: autonomous nervous system; coronary artery disease; heart failure; heart rate, heat shock proteins; vagus nerve stimulation