by Peter J. Schwartz, Maria Teresa La Rovere, Gaetano M

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Presentation transcript:

Autonomic Modulation for the Management of Patients with Chronic Heart Failure by Peter J. Schwartz, Maria Teresa La Rovere, Gaetano M. De Ferrari, and Douglas L. Mann Circ Heart Fail Volume 8(3):619-628 May 19, 2015 Copyright © American Heart Association, Inc. All rights reserved.

Kaplan–Meier survival curves according to dichotomized baroreflex sensitivity (BRS) in patients with heart failure (A) taking and (B) not taking β-blockers, with LVEF of 30% and 26%, respectively. Kaplan–Meier survival curves according to dichotomized baroreflex sensitivity (BRS) in patients with heart failure (A) taking and (B) not taking β-blockers, with LVEF of 30% and 26%, respectively. Reprinted from La Rovere et al4 with permission of the publisher. Copyright © 2009 American College of Cardiology Foundation. Published by Elsevier Inc. Peter J. Schwartz et al. Circ Heart Fail. 2015;8:619-628 Copyright © American Heart Association, Inc. All rights reserved.

Effects of electric stimulation on the neural discharge of a single efferent cardiac vagal fiber in an anesthetized cat. Effects of electric stimulation on the neural discharge of a single efferent cardiac vagal fiber in an anesthetized cat. A, Spontaneous activity, (B) electric stimulation (5 V,1.5 ms, 30 Hz) of the cut central end of the left cervical vagus, and (C) electric stimulation (10 V, 1.5 ms, 30 Hz) of the cut central end of the left inferior cardiac nerve. Effects of electric stimulation on the discharge of a single efferent cardiac sympathetic fiber in an intact, anesthetized cat. D, Electric stimulation (6 V,1.5 ms, 30 Hz) of the cut central end of the left vagus and (E) electric stimulation (10 V, 1.5ms, 30 Hz) of the cut central end of the inferior cardiac nerve. The tracings in each section are from top to bottom: respiration (positive-pressure inflation is an upward deflection), systemic arterial blood pressure, ECG, and neural activity. Reprinted from Schwartz et al19 with permission of the publisher. Copyright © 1973, Wolters Kluwer Health. Peter J. Schwartz et al. Circ Heart Fail. 2015;8:619-628 Copyright © American Heart Association, Inc. All rights reserved.

Effect of vagal stimulation over time: (A) change after 6 months in left ventricular end-systolic volume index in 29 patients; (B) in LVEF after 1 year in 23 patients; and (C) change in the 6-minute walk test after 2 years in 19 patients. Effect of vagal stimulation over time: (A) change after 6 months in left ventricular end-systolic volume index in 29 patients; (B) in LVEF after 1 year in 23 patients; and (C) change in the 6-minute walk test after 2 years in 19 patients. Reprinted from De Ferrari et al8 with permission of the publisher. Copyright © 2015, Oxford University Press. Peter J. Schwartz et al. Circ Heart Fail. 2015;8:619-628 Copyright © American Heart Association, Inc. All rights reserved.

Mean and 95% confidence intervals of echocardiographic changes after 6 months of autonomic regulation therapy (overall, left-side treatment, and right-side treatment). Mean and 95% confidence intervals of echocardiographic changes after 6 months of autonomic regulation therapy (overall, left-side treatment, and right-side treatment). LVEF indicates left ventricular ejection fraction; LVESV, left ventricular end-systolic volume; LVESD, left ventricular end-systolic diameter. Reprinted from Premchand et al20 with permission of the publisher. Copyright @ 2014, Elsevier Inc. Peter J. Schwartz et al. Circ Heart Fail. 2015;8:619-628 Copyright © American Heart Association, Inc. All rights reserved.