From the Departments of Internal Medicine and Human Physiology, Division
of Cardiovascular Medicine, University of California (K.F.P., S.V.R., J.C.L.);
the Department of Physiology, Shanghai Medical University, Shanghai, China
(P.L.); and the Department of Anesthesiology, Bowman Gray School of Medicine,
Wake Forest University Medical Center, Winston-Salem, NC (H.-L.P.).
Correspondence to John Longhurst, MD, PhD, Division of Cardiovascular Medicine, University of California, Davis, CA 95616. E-mail jclonghurst{at}ucdavis.edu
Background—Acupuncture is reported
to reduce myocardial ischemia, arrhythmias, and
hypertension. To investigate the physiological
mechanisms underlying these observations, a model of reflex-induced,
reversible myocardial ischemia was developed to test the
effects of median nerve stimulation as a surrogate for
electroacupuncture.
Methods and Results—Chloralose-anesthetized cats were
instrumented to measure arterial blood pressure, left
ventricular pressure, left ventricular dP/dt,
heart rate, left anterior descending (LAD) coronary blood
velocity, and regional wall motion. The LAD artery either was partially
occluded or a small diagonal branch was ligated. Subsequently,
transient reflex activation of the cardiovascular
system was evoked by application of bradykinin (typically 1 µg/mL) to
the gallbladder, which significantly increased myocardial oxygen demand
(double product), left ventricular dP/dt, and
coronary blood velocity and caused ischemia-induced
regional dysfunction, evidenced by significant (P<.05)
reduction in normalized wall thickening (10.7±4.2% versus
-23.6±2.9%; control versus ischemia; n=7). However, when
median nerves were stimulated with low frequency (5 Hz) to mimic
electroacupuncture, bradykinin-induced change in normalized wall
thickening was significantly improved (-23.6±2.9% versus 9.8±4.9%;
ischemia versus median nerve stimulation,
P<.05) and remained augmented
Conclusions—These results suggest that stimulation of the median
nerve to mimic electroacupuncture diminishes regional myocardial
ischemia triggered by a sympathetically mediated increase in
cardiac oxygen demand. The mechanism of this effect is related to
reduction in cardiac oxygen demand, secondary to a diminished pressor
response. These data provide the first documentation of the
physiological mechanisms underlying the possible
beneficial effect of electroacupuncture in the context of restricted
coronary blood flow and augmented myocardial oxygen demand.
© 1998 American Heart Association, Inc.
Basic Science Reports
Reversal of Reflex-Induced Myocardial Ischemia by Median Nerve Stimulation
A Feline Model of Electroacupuncture
1 hour. Results were
similar in partial and complete occlusion groups. Significant
improvement in wall thickening was associated with unchanged increment
of coronary blood velocity and significantly diminished
increments of double product and diastolic blood
pressure.
Key Words: bradykinin • ischemia • coronary heart disease • angina • ultrasonics
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