Author + information
- Received January 23, 2017
- Revision received April 11, 2017
- Accepted April 19, 2017
- Published online August 7, 2017.
- Lilei Yu, MD, PhDa,
- Bing Huang, MD, PhDa,
- Sunny S. Po, MD, PhDb,
- Tuantuan Tan, MD, PhDc,
- Menglong Wang, MDa,
- Liping Zhou, MDa,
- Guannan Meng, MDa,
- Shenxu Yuan, MDa,
- Xiaoya Zhou, MD, PhDa,
- Xuefei Li, MDa,
- Zhuo Wang, MDa,
- Songyun Wang, MDa and
- Hong Jiang, MDa,∗ ()
- aDepartment of Cardiology, Renmin Hospital of Wuhan University; Cardiovascular Research Institute, Wuhan University; Hubei Key Laboratory of Cardiology, Wuhan, Hubei, China
- bHeart Rhythm Institute and Department of Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
- cDepartment of Ultrasound Imaging, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
- ↵∗Address for correspondence:
Dr. Hong Jiang, Department of Cardiology, Renmin Hospital of Wuhan University, No. 238 Jiefang Road, Wuchang District, Wuhan City, Hubei Province 430060, China.
Objectives The aim of this study was to investigate whether low-level tragus stimulation (LL-TS) treatment could reduce myocardial ischemia-reperfusion injury in patients with ST-segment elevation myocardial infarction (STEMI).
Background The authors’ previous studies suggested that LL-TS could reduce the size of myocardial injury induced by ischemia.
Methods Patients who presented with STEMI within 12 h of symptom onset, treated with primary percutaneous coronary intervention, were randomized to the LL-TS group (n = 47) or the control group (with sham stimulation [n = 48]). LL-TS, 50% lower than the electric current that slowed the sinus rate, was delivered to the right tragus once the patients arrived in the catheterization room and lasted for 2 h after balloon dilatation (reperfusion). All patients were followed for 7 days. The occurrence of reperfusion-related arrhythmia, blood levels of creatine kinase-MB, myoglobin, N-terminal pro–B-type natriuretic peptide and inflammatory markers, and echocardiographic characteristics were evaluated.
Results The incidence of reperfusion-related ventricular arrhythmia during the first 24 h was significantly attenuated by LL-TS. In addition, the area under the curve for creatine kinase-MB and myoglobin over 72 h was smaller in the LL-TS group than the control group. Furthermore, blood levels of inflammatory markers were decreased by LL-TS. Cardiac function, as demonstrated by the level of N-terminal pro–B-type natriuretic peptide, the left ventricular ejection fraction, and the wall motion index, was markedly improved by LL-TS.
Conclusions LL-TS reduces myocardial ischemia-reperfusion injury in patients with STEMI. This proof-of-concept study raises the possibility that this noninvasive strategy may be used to treat patients with STEMI undergoing primary percutaneous coronary intervention.
- acute myocardial infarction
- ischemia-reperfusion injury
- low-level vagal stimulation
- ventricular arrhythmia
This work was supported by grants 81530011, 81570463, and 81600395 from the National Nature Science Foundation of China, grants 2016CFA065 and 2016CFA048 from the Natural Science Foundation of Hubei Province, and grant WJ2017C0005 from the Foundation of Health and Family Planning Commission of Hubei Province. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose. Drs. Yu and Huang contributed equally to this work.
- Received January 23, 2017.
- Revision received April 11, 2017.
- Accepted April 19, 2017.