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09-11-2023 | Acute Heart Failure | Research Article

Noninvasive low-level tragus stimulation attenuates inflammation and oxidative stress in acute heart failure

Authors: Tarun W. Dasari, Praloy Chakraborty, Peter Mukli, Khawaja Akhtar, Andriy Yabluchanskiy, Madeleine W. Cunningham, Anna Csiszar, Sunny S. Po

Published in: Clinical Autonomic Research | Issue 6/2023

Abstract

Purpose

Acute decompensated heart failure (ADHF) is associated with inflammation, oxidative stress, and excess sympathetic drive. It is unknown whether neuromodulation would improve inflammation and oxidative stress in acute heart failure. We, therefore, performed this proof-of-concept study to evaluate the effects of neuromodulation using noninvasive low-level tragus stimulation on inflammation and oxidative stress in ADHF.

Methods

Nineteen patients with ejection fraction < 40% were randomized to neuromodulation 4 h twice daily (6–10 a.m. and 6–10 p.m.) (n = 8) or sham stimulation (n = 11) during hospital admission. All patients received standard-of-care treatment. Blood samples were collected at admission and discharge. Serum cytokines were assayed using standard immunosorbent techniques. Reactive oxygen species inducibility from cultured coronary endothelial cells exposed to patient sera was determined using a dihydrodichlorofluorescein probe test (expressed as fluorescein units).

Results

Compared to sham stimulation, neuromodulation was associated with a significant reduction of circulating serum interleukin-6 levels (−78% vs. −9%; p = 0.012). Similarly, neuromodulation led to a reduction of endothelial cell oxidative stress in the neuromodulation group (1363 units to 978 units, p = 0.003) compared to sham stimulation (1146 units to 1083 units, p = 0.094). No significant differences in heart rate, blood pressure, or renal function were noted between the two groups.

Conclusion

In this proof-of-concept pilot study, in acute decompensated heart failure, neuromodulation was feasible and safe and was associated with a reduction in systemic inflammation and attenuation of coronary endothelial cellular oxidative stress.

Clinical trial registration

NCT02898181.

Graphical abstract

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Title: Noninvasive low-level tragus stimulation attenuates inflammation and oxidative stress in acute heart failure
Authors: Tarun W. Dasari
Praloy Chakraborty
Peter Mukli
Khawaja Akhtar
Andriy Yabluchanskiy
Madeleine W. Cunningham
Anna Csiszar
Sunny S. Po
Publication date: 09-11-2023
Publisher: Springer Berlin Heidelberg
Keywords: Acute Heart Failure
Nerve Stimulation
Heart Failure
Cytokines
Published in: Clinical Autonomic Research / Issue 6/2023
Print ISSN: 0959-9851
Electronic ISSN: 1619-1560
DOI: https://doi.org/10.1007/s10286-023-00997-z

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Springer Medicine

Noninvasive low-level tragus stimulation attenuates inflammation and oxidative stress in acute heart failure

Abstract

Purpose

Methods

Results

Conclusion

Clinical trial registration

Graphical abstract

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

Clinical trial registration

Graphical abstract

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