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
This article has been cited by other articles:
 |
|
 |
|
  E. Stener-Victorin, E. Jedel, P. O. Janson, and Y. B. Sverrisdottir Low-frequency electroacupuncture and physical exercise decrease high muscle sympathetic nerve activity in polycystic ovary syndrome Am J Physiol Regulatory Integrative Comp Physiol, August 1, 2009; 297(2): R387 - R395. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 W. Zhou, A. Mahajan, and J. C. Longhurst Spinal nociceptin mediates electroacupuncture-related modulation of visceral sympathoexcitatory reflex responses in rats Am J Physiol Heart Circ Physiol, August 1, 2009; 297(2): H859 - H865. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. C. Tjen-A-Looi, P. Li, and J. C. Longhurst Processing cardiovascular information in the vlPAG during electroacupuncture in rats: roles of endocannabinoids and GABA J Appl Physiol, June 1, 2009; 106(6): 1793 - 1799. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L.-W. Fu and J. C. Longhurst Electroacupuncture modulates vlPAG release of GABA through presynaptic cannabinoid CB1 receptors J Appl Physiol, June 1, 2009; 106(6): 1800 - 1809. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Li, S. C. Tjen-A-Looi, Z.-L. Guo, L.-W. Fu, and J. C. Longhurst Long-loop pathways in cardiovascular electroacupuncture responses J Appl Physiol, February 1, 2009; 106(2): 620 - 630. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Komori, K. Takada, Y. Tomizawa, K. Nishiyama, I. Kondo, M. Kawamata, and M. Ozaki Microcirculatory Responses to Acupuncture Stimulation and Phototherapy Anesth. Analg., February 1, 2009; 108(2): 635 - 640. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J.-H. Lin, C.-H. Shih, K. Kaphle, L.-S. Wu, W.-Y. Tseng, J.-H. Chiu, T.-c. Lee, and Y.-L. Wu Acupuncture Effects on Cardiac Functions Measured by Cardiac Magnetic Resonance Imaging in a Feline Model Evid. Based Complement. Altern. Med., January 23, 2008; (2008) nem187v1. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. C. Tjen-A-Looi, P. Li, and J. C. Longhurst Role of medullary GABA, opioids, and nociceptin in prolonged inhibition of cardiovascular sympathoexcitatory reflexes during electroacupuncture in cats Am J Physiol Heart Circ Physiol, December 1, 2007; 293(6): H3627 - H3635. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. L. Lujan, V. J. Kramer, and S. E. DiCarlo Electroacupuncture decreases the susceptibility to ventricular tachycardia in conscious rats by reducing cardiac metabolic demand Am J Physiol Heart Circ Physiol, May 1, 2007; 292(5): H2550 - H2555. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. C. Longhurst Electroacupuncture treatment of arrhythmias in myocardial ischemia Am J Physiol Heart Circ Physiol, May 1, 2007; 292(5): H2032 - H2034. [Full Text] [PDF]
|
|
|
|
|
|
W. Zhou, L.-W. Fu, Z.-L. Guo, and J. C. Longhurst Role of glutamate in the rostral ventrolateral medulla in acupuncture-related modulation of visceral reflex sympathoexcitation Am J Physiol Heart Circ Physiol, April 1, 2007; 292(4): H1868 - H1875. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. Zhou, L.-W. Fu, S. C. Tjen-A-Looi, Z.-l. Guo, and J. C. Longhurst Role of glutamate in a visceral sympathoexcitatory reflex in rostral ventrolateral medulla of cats Am J Physiol Heart Circ Physiol, September 1, 2006; 291(3): H1309 - H1318. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. Michikami, A. Kamiya, T. Kawada, M. Inagaki, T. Shishido, K. Yamamoto, H. Ariumi, S. Iwase, J. Sugenoya, K. Sunagawa, et al. Short-term electroacupuncture at Zusanli resets the arterial baroreflex neural arc toward lower sympathetic nerve activity Am J Physiol Heart Circ Physiol, July 1, 2006; 291(1): H318 - H326. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Li, S. C. Tjen-A-Looi, and J. C. Longhurst Excitatory projections from arcuate nucleus to ventrolateral periaqueductal gray in electroacupuncture inhibition of cardiovascular reflexes Am J Physiol Heart Circ Physiol, June 1, 2006; 290(6): H2535 - H2542. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. C. Tjen-A-Looi, P. Li, and J. C. Longhurst Midbrain vlPAG inhibits rVLM cardiovascular sympathoexcitatory responses during electroacupuncture Am J Physiol Heart Circ Physiol, June 1, 2006; 290(6): H2543 - H2553. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C-H Hsu, Y Hua, G-P Jong, C-L Chao, J-Y Liu, K-C Hwang, and P Chou Shock resuscitation with acupuncture: case report Emerg. Med. J., March 1, 2006; 23(3): e18 - e18. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. Zhou (Yi Syuu), I. Hsiao, V. W. H. Lin, and J. C. Longhurst Modulation of cardiovascular excitatory responses in rats by transcutaneous magnetic stimulation: role of the spinal cord J Appl Physiol, March 1, 2006; 100(3): 926 - 932. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Ventura CAM and Cell Fate Targeting: Molecular and Energetic Insights into Cell Growth and Differentiation Evid. Based Complement. Altern. Med., September 1, 2005; 2(3): 277 - 283. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. Zhou (Yi Syuu), S. C. Tjen-A-Looi, and J. C. Longhurst Brain stem mechanisms underlying acupuncture modality-related modulation of cardiovascular responses in rats J Appl Physiol, September 1, 2005; 99(3): 851 - 860. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. H.K. Vogel, S. F. Bolling, R. B. Costello, E. M. Guarneri, M. W. Krucoff, J. C. Longhurst, B. Olshansky, K. R. Pelletier, C. M. Tracy, R. A. Vogel, et al. Integrating Complementary Medicine Into Cardiovascular Medicine: A Report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents (Writing Committee to Develop an Expert Consensus Document on Complementary and Integrative Medicine) J. Am. Coll. Cardiol., July 5, 2005; 46(1): 184 - 221. [Full Text] [PDF]
|
|
|
|
|
|
M. M. Crisostomo, P. Li, S. C. Tjen-A-Looi, and J. C. Longhurst Nociceptin in rVLM mediates electroacupuncture inhibition of cardiovascular reflex excitatory response in rats J Appl Physiol, June 1, 2005; 98(6): 2056 - 2063. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. Zhou, L.-W. Fu, S. C. Tjen-A-Looi, P. Li, and J. C. Longhurst Afferent mechanisms underlying stimulation modality-related modulation of acupuncture-related cardiovascular responses J Appl Physiol, March 1, 2005; 98(3): 872 - 880. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. C. Tjen-A-Looi, P. Li, and J. C. Longhurst Medullary substrate and differential cardiovascular responses during stimulation of specific acupoints Am J Physiol Regulatory Integrative Comp Physiol, October 1, 2004; 287(4): R852 - R862. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Syuu, H. Matsubara, S. Hosogi, and H. Suga Pressor effect of electroacupuncture on hemorrhagic hypotension Am J Physiol Regulatory Integrative Comp Physiol, December 1, 2003; 285(6): R1446 - R1452. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J.-H. Chiu, M.-T. Tsou, H.-H. Tung, C.-H. Tai, S.-K. Tsai, C.-L. Chih, J.-G. Lin, and C.-W. Wu Preconditioned somatothermal stimulation on median nerve territory increases myocardial heat shock protein 70 and protects rat hearts against ischemia-reperfusion injury J. Thorac. Cardiovasc. Surg., March 1, 2003; 125(3): 678 - 685. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Li, K. Rowshan, M. Crisostomo, S. C. Tjen-A-Looi, and J. C. Longhurst Effect of electroacupuncture on pressor reflex during gastric distension Am J Physiol Regulatory Integrative Comp Physiol, December 1, 2002; 283(6): R1335 - R1345. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H.-L. Pan, D. D. Deal, Z. Xu, and S.-R. Chen Differential responses of regional sympathetic activity and blood flow to visceral afferent stimulation Am J Physiol Regulatory Integrative Comp Physiol, June 1, 2001; 280(6): R1781 - R1789. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. R. Middlekauff, J. L. Yu, and K. Hui Acupuncture effects on reflex responses to mental stress in humans Am J Physiol Regulatory Integrative Comp Physiol, May 1, 2001; 280(5): R1462 - R1468. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 X. Zhou, F. L. Vance IV, A. L. Sims, C. M. Sreenan, and R. E. Ideker Prevention of High Incidence of Neurally Mediated Ventricular Arrhythmias by Afferent Nerve Stimulation in Dogs Circulation, February 22, 2000; 101(7): 819 - 824. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. M. Chao, L. L. Shen, S. Tjen-A-Looi, K. F. Pitsillides, P. Li, and J. C. Longhurst Naloxone reverses inhibitory effect of electroacupuncture on sympathetic cardiovascular reflex responses Am J Physiol Heart Circ Physiol, June 1, 1999; 276(6): H2127 - H2134. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. O. Cheng, C. Mannheimer, T. Eliasson, H. Norrsell, L.-E. Augustinsson, C. Blomtrand, H. Emanuelsson, S. Larsson, and A. Hjalmarson Acupuncture for Relief of Angina • Response Circulation, November 24, 1998; 98 (21): 2357 - 2358. [Full Text] [PDF]
|
|