Spinal cord stimulation treatment for angina pectoris: more than a placebo?

Détails

ID Serval
serval:BIB_46AF68CB6613
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Spinal cord stimulation treatment for angina pectoris: more than a placebo?
Périodique
The Annals of thoracic surgery
Auteur(s)
Gersbach P.A., Hasdemir M.G., Eeckhout E., von Segesser L.K.
ISSN
0003-4975
Statut éditorial
Publié
Date de publication
2001
Peer-reviewed
Oui
Volume
72
Numéro
3
Pages
S1100-4
Langue
anglais
Notes
Publication types: Journal Article - Publication Status: ppublish
Résumé
BACKGROUND: The effects of thoracolumbal spinal cord stimulation (SCS) are confined to restricted microcirculatory areas. This limitation is generally attributed to a predominantly segmental mode of action on the autonomic nervous system. The goal of this study was to determine whether SCS applied close to supraspinal autonomic centers would induce generalized hemodynamic changes that could explain its alleged antianginal properties. METHODS: Invasive hemodynamic tests were performed in 15 anesthetized Göttingen minipigs submitted to iterative cervical SCS of various duration and intensity. RESULTS: Hemodynamic changes exceeding 10% were observed in 59 of 68 SCS sessions (87%). Their extent and time to peak varied with SCS intensity. At 2, 5, and 10 V, significant (t test p < 0.05) peak changes occurred in cardiac output (+34%, +29%, and +28%, respectively), stroke volume (+19%, +16%, +15%), mean pressure (+9%, +27%, +40%), heart rate (+14%, +23%, +14%), systemic (-17%, NS, NS), and pulmonary vascular (25%, NS, NS) resistances. Strikingly, at 2 V, the increase in cardiac output (+34%) was higher than the synchronous rise in rate pressure product (+22%), indicating efficient cardiac work. At 10 V, however, the cardiac work was inefficient (rate pressure product + 53%/cardiac output + 28%). CONCLUSIONS: Low-voltage cervical neuromodulation reduces the postcharge and improves cardiac work efficiency. The resulting reduction in oxygen myocardial demand may account for decreased anginal pain.
Mots-clé
Angina Pectoris, Animals, Electric Stimulation Therapy, Electrocardiography, Electrodes, Implanted, Hemodynamics, Spinal Cord, Swine, Miniature
Pubmed
Web of science
Création de la notice
28/01/2008 10:51
Dernière modification de la notice
20/08/2019 14:52
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