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首页> 外文期刊>Journal of cardiovascular translational research. >Increasing Blood Pressure by Greater Splanchnic Nerve Stimulation: a Feasibility Study
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Increasing Blood Pressure by Greater Splanchnic Nerve Stimulation: a Feasibility Study

机译:通过更大的内脏神经刺激增加血压:可行性研究

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The splanchnic vascular compartment is the major reservoir for intravascular blood volume, and dysregulation of the compartment was implicated in a series of cardiovascular conditions. We explored feasibility and effectiveness of an implantable cuff system on the greater splanchnic nerve (GSN) in healthy canines for short- and long-term neuromodulation to affect the circulation. Five mongrel hounds underwent minimally invasive right-sided unilateral GSN cuff placement. All animals underwent same day GSN stimulation and repeat stimulation at 9-30 days. Stimulation parameter optimization was conducted both acutely and chronically. Parameters ranged from 1-250 Hz, 0.25 mA-35 mA, 0.1-0.5 ms, and 30-s pulse duration. Two animals were survived for 9 days and 3 animals for 30 days. Stimulation of the right GSN increased mean arterial blood pressure by 36.9 mmHg ± 13.4 (p < 0.0001), central venous pressure by 6.9 mmHg ± 1.7 (p < 0.0001), and mean pulmonary arterial pressure by 6.3 mmHg ± 2.0 (p < 0.0001). Peak effects were observed within 30 s, and magnitude of effects was comparable between stimulation cycles (p = 0.4). Stimulation-induced changes in hemodynamics were independent of afferent nerve fibers (pain response) or the adrenal gland. Necropsy showed no evidence of nerve damage on histologic studies up to 30 days after implantation. GSN stimulation via an implanted nerve cuff provided a reproducible and rapid method to increase arterial, central venous, and pulmonary arterial pressures. The neuromodulation cuff was well tolerated and elicited a response up to 30 days after implantation. The clinical application of GSN stimulation as a tool to change central and peripheral cardiovascular hemodynamics needs to be explored.
机译:内脏血管隔室是血管内血容量的主要储存库,内脏血管隔室的失调与一系列心血管疾病有关。我们探索了植入式袖带系统对健康犬科动物内脏大神经(GSN)的可行性和有效性,用于短期和长期神经调控以影响循环。5只猎犬行微创右侧单侧GSN袖带置位术。所有动物在同一天接受GSN刺激,并在9-30天时重复刺激。刺激参数优化以急性和慢性两种方式进行。参数范围为 1-250 Hz、0.25 mA-35 mA、0.1-0.5 ms 和 30-s 脉冲持续时间。2只动物存活9天,3只存活30天。刺激右侧GSN使平均动脉血压增加36.9 mmHg±13.4(p < 0.0001),中心静脉压增加6.9 mmHg±1.7(p < 0.0001),平均肺动脉压增加6.3 mmHg±2.0(p < 0.0001)。在30秒内观察到峰值效应,并且刺激周期之间的效应程度相当(p = 0.4)。刺激诱导的血流动力学变化与传入神经纤维(疼痛反应)或肾上腺无关。尸检在植入后 30 天内的组织学检查中没有显示神经损伤的证据。通过植入的神经袖带进行 GSN 刺激提供了一种可重复且快速的方法,以增加动脉、中心静脉和肺动脉压。神经调控袖带耐受性良好,并在植入后长达 30 天引起反应。GSN刺激作为改变中枢和外周心血管血流动力学的工具的临床应用有待探索。

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