Abstract 12286: Electrical Muscle Stimulation Improves Neurovascular Control and Exercise Tolerance in Hospitalised Advanced Heart Failure Patients
Introduction: Advanced heart failure (HF) patients may stay for a long period of time in the hospital for the treatment of HF and prolonged inactivity causes complications that result in worsening of exercise tolerance. On the other hand, there is evidence that treatment with muscle low-frequency electrical stimulation (FES) provides important benefits for HF patients. This study investigated the effects of FES on neurovascular control and exercise tolerance in HF hospitalized patients.
Methods and results: Thirty hospitalized patients for treatment of decompensated HF, functional class IV NYHA and ejection fraction ≤ 30% were consecutively randomised into two groups: 1) FES(n= 15; 54±2 years) and control(n= 15; 49±2 years). Muscle sympathetic nerve activity (MSNA) was directly recorded via microneurography and blood flow by venous occlusion plethysmography. Heart rate and blood pressure were evaluated on a beat-to-beat basis (Finometer). Exercise tolerance by six-minute walk test, quadriceps muscle strength by a dynamometer and quality of life by Minnesota Questionnaire. FES consisted of stimulating the lower limbs at 10 Hz frequency, 150 ms pulse width and 70 mA intensity for 60 min/day for 7 days/week for 10 consecutive days. The control group underwent electrical stimulation at intensity of 20 mA. Baseline characteristics were similar between groups, except age that was higher in FES group. FES significantly decreased MSNA burst frequency (49 ±5 vs. 35±5, P= 0.002) and burst incidence (61 ±6 vs. 49±7, P= 0.04). In addition, FES significantly increased leg blood flow (0.88 ±0.09 vs. 1.47 ±0.14, P<0.001) and muscle strength (13 ±1 to 21 ±2, P<0.001). No changes were found in control group. Walking distance (304 ±25 to 436 ±26, P<0.001 vs. 320 ±22 to 358 ±22, P= 0.001) and quality of life (69 ±5 to 26 ±3, P<0.001 vs. 70 ±3 to 45 ±3, P<0.001) improved in FES and control groups, respectively. However, these changes were greater in FES group.
Conclusion: FES improves MSNA and vasoconstriction and increases exercise tolerance, muscle strength and quality of life in hospitalised HF patients. These findings support the use of FES as an adjuvant therapy for patients hospitalised to achieve the stabilisation of HF.
Author Disclosures: R.V. Groehs: None. L.M. Antunes-Correa: None. T.S. Nobre: None. M.N. Alves: None. M.P. Rondon: None. A. Pereira-Barretto: None. C.E. Negrao: None.
- © 2015 by American Heart Association, Inc.