The spectrogram of heart rate in cats following burst stimulation of the vagus nerve

Denervation of the heart (bilateral vagotomy and propranolol) in artificially ventilated cats didn't remove respiratory peaks on the spectrogram of heart rate, while burst stimulation of vagus nerve increased or decreased them several times by synchronization of the heart and vagus rhythms, which in its turn was observed under the bradycardia only. At the same time, the desynchronization of rhythms provoked severe sinus arrhythmia which had a distinct periodic character. Under these conditions, there were high non-respiratory peaks appearing at the spectrogram of the heart rate that indicated existence of two vagus chronotropic effects: a well known tonic one and special intracycle synchronizing effect correcting duration of every cardiac cycle.     

Mechanisms of cutaneous-cardial interconnections

Using the method of double stimuli, some features of inhibitory influences of conditioning stimulation of cutaneous zones on the afferent transmission from the heart were studied in the experiments on cats. It has been shown that when the interval between testing and conditioning stimuli is from 50 to 150 ms, the cutaneous stimulations effectively block the appearance of evoked potentials in the rostral parts of the cerebral cortex, which were induced by the electrical stimulation of the sinoatrial nodal zone. Bilateral vagotomy completely eliminated this reaction. Stimulation of the peripheral part of the cut vagus also effectively blocked the transmission of the afferent impulses from the heart. It was concluded that inhibitory cutaneo-cardiac effects are determined by the mechanisms of presynaptic inhibition, which develop at the level of intracardiac nervous system.     

Respiratory Cardiac Arrhythmia in Postnatal Ontogenesis of Rats

Development of the respiratory cardiac arrhythmia and the role of parasympathetic nervous system in its origin have been studied in rats aged from 4–6 days to 6 months of life. In rat pups of the first week of life, small fluctuations of cardiac rhythm were observed with the frequency close to fluctuations of respiratory rhythm. However, at this age they had neither regular character nor clear connection with phases of the respiratory cycle. On the 2–3rd week the amplitude of fluctuations rose and their association with respiration was established; however, unlike the respiratory arrhythmia observed in other animals and human, in rat pups there was deceleration but not acceleration of heart beating. By to the 6-week age the respiratory arrhythmia reached the maximal values, then its amplitude began to decrease. Bilateral transection of the vagus nerves in rat pups did not cause reduction of the respiratory arrhythmia. Thus, in rats the central influences on the heart can be transduced by bypassing the system of vagus nerves.     

Selective pharmacological blocking of synaptic transmission through the parasympathetic ganglia: Effects on the cardiovascular system

In acute experiments on rats and dogs, compounds IEM-1556 and IEM-1678, the blockers of transmission through the parasympathetic ganglia, reduced the negative chronotropic effect of stimulation of the vagus nerve (VN), while practically not changing the heart rate (HR). In chronic experiments on dogs, these compounds increased the HR, substantially reduced the respiratory heart arrhythmia, did not change the arterial blood pressure (AP), and reduced the chronotropic effects of VN stimulation. IEM-1556 exerted more strong and long-lasting blocking effects on vagal heart control than IEM-1678 did, but in anesthetized animals could evoke a drop in the AP. Acetylcholine, if administered during the action of the above compounds, inhibited heart activity. It is concluded that both IEM-1678 and IEM-1556 are selective parasympatholytics (although IEM-1556 may produce a side effect). The above compounds block synaptic transmission through the intracardiac parasympathetic ganglia and do not affect neuro-effector transmission in the heart.Neirofiziologiya/Neurophysiology, Vol. 28, No. 2/3, pp. 151–159, March–June, 1996.     

The structural dynamics of vagus influence on the heart rhythm in exposures directed at altering the acting acetylcholine concentration]

In 29 experiments on anaesthetized cats burst stimulation of peripheral cut end of right vagus nerve leads to synchronization of heart and vagus rhythm. Influence of proserine, pilocarpine and prolonged vagus stimulation upon extent of vagus chronotropic effect and its components--tonic and synchronizing--was investigated. In all cases changes of vagus chronotropic effect during this actions were caused by unidirectional shifts of tonic component. Extent of synchronizing vagus chronotropic influences did not depend on the changes of acetylcholine concentration.     

Mortality and Suicide Risk in Treatment-Resistant Depression: An Observational Study of the Long-Term Impact of Intervention

Major depressive disorder is a common global disease that causes a significant societal burden. Most interventional studies of depression provide a limited assessment of the interventions on mortality and suicide risks. This study utilizes data from an observational registry of patients with major depressive disorder to determine the impact of intervention (vagus nerve stimulation or standard pharmacological/non-pharmacological therapy) and a latent factor, patient trajectory toward response, on mortality, suicide and suicidal ideation. A total of 636 patients were available for an intent-to-treat analysis of all-cause mortality, suicide and suicidal ideation. Patients treated with vagus nerve stimulation in addition to standard therapies experienced lower, but not statistically significant, all-cause mortality (vagus nerve stimulation 4.93 per 1,000 person-years vs. 10.02 per 1,000 patient years for treatment as usual) and suicide rates (vagus nerve stimulation 0.88 per 1,000 person-years vs. 1.61 per 1,000 patient years for treatment as usual). Treatment with vagus nerve stimulation produced a statistically lower relative risk of suicidal ideation 0.80, 95% confidence interval (0.68,0.95). Further, patients that responded to either treatment saw a 51% reduction in relative risk of suicidal behavior; relative risk and 95% confidence interval of 0.49 (0.41,0.58). In summary, we find that treatment with adjunctive vagus nerve stimulation can potentially lower the risk of all-cause mortality, suicide and suicide attempts.     

Modification of vagal action on the toad heart by changes in flow

Summary Hearts of toads (Bufo marinus) were perfused in situ with oxygenated Ringer's solution. The flow of the perfusate was varied during periods of vagal stimulation and in the absence of vagal stimulation. Pulse interval and cardiac contraction were monitored, and results only from those animals that showed no change in pulse interval with changes in flow in the absence of vagal stimulation were used. In these animals, during vagal stimulation, cardiac slowing was greater when flow was low than when it was high. In addition, in cases where vagal stimulation caused atrio-ventricular block, the block could be reversed by an increase in flow of the perfusate. The results are consistent with flow through the heart being an important determinant of the concentration of neurally released ACh at the pacemaker sites and therefore of the effectiveness of the vagus nerve.     

Chronic atropine administration diminishes the contribution of vasoactive intestinal polypeptide to heart rate regulation

Vasoactive intestinal polypeptide (VIP) is implicated in the modulation of vagal effects on the heart rate. In this study, the impact of acute and chronic atropine administration on VIP levels in rat heart atria was investigated in relation to heart rate in the course of vagus nerves stimulation. Anaesthetised control and atropinised (10 mg/kg/day for 10 days) rats pretreated with metipranolol and phentolamine that were either given or not a single dose of atropine were subjected to bilateral vagus nerve stimulation (30 min: 0.7 mA, 20 Hz, 0.2 ms). VIP concentrations in the atria were determined after each stimulation protocol. In control rats with or without single atropine administration, the heart rate upon vagal stimulation was higher than in atropinised animals with or without single atropine dose, respectively. VIP concentrations in the control atria were significantly decreased after the stimulation; the decrease was comparable both in the absence and presence of a single dose of atropine. Compared to controls, VIP levels were significantly decreased after chronic atropine treatment and they were not further reduced by vagal stimulation and single atropine administration. Administration of VIP antagonist completely abolished the differences in the heart rate upon vagal stimulation between control and atropinised groups. In conclusion, the data indicate that chronic atropine administration affects VIP synthesis in rat heart atria and consequently it modifies the heart rate regulation.     

Role of neuropeptide Y Y(2) receptors in modulation of cardiac parasympathetic neurotransmission.

The aim of the study was to clarify the role of the Y(2) receptor in regulation of vagal control of the heart, using Y(2)((-/-)) receptor-knockout mice. Adult Y(2)((+/+),(-/-)) mice (50% C57BL/6-50% 129/SvJ background) were anaesthetised and artificially ventilated. Arterial blood pressure and pulse interval was recorded and both vagus nerves were cut. The cardiac end of the right vagus nerve was stimulated supra-maximally every 30 s (7 V, 2-2.5 Hz, 5 s). Neuropeptide Y (NPY) and a Y(2) receptor agonist, N-acetyl [Leu(28, 31)]NPY 24-36, were injected intravenously in both groups of mice. N-acetyl [Leu(28, 31)] NPY 24-36 was also administered to control mice in the presence of a Y(2) receptor antagonist, BIIE0246. Stimulation of the vagus nerve increased pulse interval (PI) by approximately 100 ms. NPY and N-acetyl [Leu(28, 31)] NPY 24-36 attenuated the increase in PI evoked by vagal stimulation in control mice only. The attenuation was reduced in the presence of BIIE0246. The results presented here show in Y(2)((-/-)) receptor-knockout mice that NPY and N-acetyl [Leu(28, 31)] NPY 24-36 have no effect on PI evoked by vagal stimulation. These findings demonstrate that NPY attenuates parasympathetic activity to the heart via the Y(2) receptor.     

Characteristics of cardiac regulation in ischemic damage to the ventricular myocardium

The evoked potentials produced by the irritation of the heart sinus node zone in the brain cortex and bradycardia have been registered in 5 to 40-min ischemia of the left and right ventricular myocardium during the electrical stimulation of the vagus. Restricted cardiac afferentation and the heart escape from vagus influences have been revealed at the early stages of ischemia.     

迷走神经兴奋性对HRV的影响及其机制的初步分析

实验在氯醛糖加氨基甲酸乙酯麻醉的新西兰兔上进行。记录血压,心率,心电图和心率变异性频谱分析。电刺激减压神经,疑核和右侧迷走神经外周端,均引起心率和血压下降,总变异性,低频成分,高频成分,ＬＦ／ＨＦ比值和极代频成分增大。静脉注射阿托品可使上述反应显著减小,而静脉注射心得安仅可阻断ＤＮ和ＮＡ所致ＬＦ的增大。     

Human Vagus Nerve Branching in the Cervical Region

BackgroundVagus nerve stimulation is increasingly applied to treat epilepsy, psychiatric conditions and potentially chronic heart failure. After implanting vagus nerve electrodes to the cervical vagus nerve, side effects such as voice alterations and dyspnea or missing therapeutic effects are observed at different frequencies. Cervical vagus nerve branching might partly be responsible for these effects. However, vagus nerve branching has not yet been described in the context of vagus nerve stimulation.ResultsCervical vagus nerve branching was observed in 29% of all cases (26% unilaterally, 3% bilaterally) and proven histologically in all cases. Right-sided branching (22%) was more common than left-sided branching (12%) and occurred on the level of the fourth and fifth vertebra on the left and on the level of the second to fifth vertebra on the right side. Vagus nerves without branching were significantly larger than vagus nerves with branches, concerning their diameters (4.79 mm vs. 3.78 mm) and cross-sections (7.24 mm² vs. 5.28 mm²).DiscussionCervical vagus nerve branching is considerably more frequent than described previously. The side-dependent differences of vagus nerve branching may be linked to the asymmetric effects of the vagus nerve. Cervical vagus nerve branching should be taken into account when identifying main trunk of the vagus nerve for implanting electrodes to minimize potential side effects or lacking therapeutic benefits of vagus nerve stimulation.     

Somatostatin as a modulator of vagal effects on heart rhythm]

In 11 experiments on anesthetised cats burst stimulation of peripheral cut end of right vagus nerve leads to synchronization of cardiac and vagus rhythms. Alterations of burst sequence frequency within definite limits has been synchronously reproduced by heart thus creating managed bradycardia possibility. Somatostatin (10(-8)-10(-9) M intravenously) decreases heart rate and inhibits total vagus chronotropic effect. Vagolytic effect of somatostatin caused a decrease of tonic component of the vagus chronotropic effect. On the other hand, somatostatin augmented the extent of the vagal synchronizing influences and caused enlargement of the ranges of managed bradycardia. The observed results testify to participation of the peptidergic mechanisms in genesis of vagal managed bradycardia.     

The modulatory effects of noradrenaline on vagal control of heart rate in the dogfish,Squalus acanthias

The possible interactions between inhibitory vagal control of the heart and circulating levels of catecholamines in dogfish (Squalus acanthias) were studied using an in situ preparation of the heart, which retained intact its innervation from centrally cut vagus nerves. The response to peripheral vagal stimulation typically consisted of an initial cardiac arrest, followed by an escape beat, leading to renewed beating at a mean heart rate lower than the prestimulation rate (partial recovery). Cessation of vagal stimulation led to a transient increase in heart rate, above the prestimulation rate. This whole response was completely abolished by 10(-4) M atropine (a muscarinic cholinergic antagonist). The degree of vagal inhibition was evaluated in terms of both the initial, maximal cardiac interval and the mean heart rate during partial recovery, both expressed as a percentage of the prestimulation heart rate. The mean prestimulation heart rate of this preparation (36+/-4 beats min(-1)) was not affected by noradrenaline but was significantly reduced by 10(-4) M nadolol (a beta-adrenergic receptor antagonist), suggesting the existence of a resting adrenergic tone arising from endogenous catecholamines. The degree of vagal inhibition of heart rate varied with the rate of stimulation and was increased by the presence of 10(-8) M noradrenaline (the normal in vivo level in routinely active fish), while 10(-7) M noradrenaline (the in vivo level measured in disturbed or deeply hypoxic fish) reduced the cardiac response to vagal stimulation. In the presence of 10(-7) M noradrenaline, 10(-4) M nadolol further reduced the vagal response, while 10(-4) M nadolol + 10(-4) M phentolamine had no effect, indicating a complex interaction between adrenoreceptors, possibly involving presynaptic modulation of vagal inhibition.     

Effect of the autonomic nervous system on the resistance of heart ventricles to fibrillation

Effects of vagus stimulation and cutting on the tolerance of heart ventricles to fibrillation in cats have been studied. The parasympathetic effects increased the tolerance of heart ventricles to fibrillation while sympathetic ones--decreased it.     

Mechanisms of altered vagal control in heart failure: influence of muscarinic receptors and acetylcholinesterase activity

Parasympathetic control of the heart is attenuated in heart failure (HF). We investigated possible mechanisms and sites of altered vagal control in dogs with HF induced by rapid pacing. Muscarinic blockade reduced the R-R interval by 308 ms in controls but only by 32 ms in HF, indicating low levels of resting vagal tone. Vagomimetic doses of atropine sulfate prolonged the R-R interval by 109 ms in controls and increased standard deviation of the R-R interval by 66 ms but only by 46 and 16 ms, respectively, in HF. Bradycardia elicited by electrical stimulation of the vagus nerve was also attenuated in the HF group. Conversely, muscarinic receptor activation by bethanechol, and indirectly by neostigmine, elicited exaggerated R-R interval responses in HF. To investigate possible mechanisms, we measured muscarinic receptor density (Bmax) and acetylcholinesterase activity in different areas of the heart. In sinoatrial nodes, Bmax was increased (230 +/- 75% of control) and acetylcholinesterase decreased (80 +/- 6% of control) in HF. We conclude that muscarinic receptors are upregulated and acetylcholinesterase is reduced in the sinus node in HF. Therefore, reduced vagal control in HF is most likely due to changes of presynaptic function (ganglionic), because postsynaptic mechanisms augment vagal control in HF.     

Elimination of disorders in the electrical stability of the heart during postinfarct cardiosclerosis by using a factor that induces GABA accumulation in the brain

It was shown that disturbances of the heart electrical stability in postinfarction cardiosclerosis manifested in a fall of the electrical threshold of the heart fibrillation and the development of extrasystoles during the vagus stimulation. These disturbances were effectively eliminated by administration of GABA in the brain.     

Increase of cardiodepressant activity in medium incubating the posterior pituitary lobe in situ during vagal nerve stimulation in rat.

Previous studies have indicated that there is a cardiodepressant factor in the medium incubating the posterior pituitary lobe in situ. The cardiodepressant activity of the medium incubating the posterior pituitary lobe before and during stimulation of the vagus nerves was tested on isolated auricles of the right heart atrium of a two-day-old rat. It was found that the medium incubating the posterior pituitary lobe collected before stimulation decreased the contraction rate of the auricle by 34%, while that collected during the intermittent stimulation of the central ends of the cut vagus nerves caused a decrease of the auricle contractions frequency by 52%. The addition of cholinergic, serotoninergic, histaminergic receptor blockers or prostaglandin synthetase into Ringer-Lock's solution bathing the auricle has no effect on the changes of the contraction rate caused by the incubation medium.     

Neuroinhibition in the regulation of emesis

Elucidation of an inhibitory system in the regulation of emesis is presented in this report. Emesis preceded by retching, can be induced in the dog by appropriate electrical stimulation of abdominal vagus nerves at the supradiaphragmatic level. Failure to produce retching or emesis by electrical stimulation of the cervical vagus trunk suggests either that the abdominal vagal emetic afferent does not course in the cervical vagus or that fibers inhibitory to emesis are present. This report presents evidence for afferent fibers inhibitory to retching and emesis in the cervical vagus. Retching and emesis resulting from stimulation of the supradiaphragmatic vagus can be prevented by either transection of the cervical vagus or simultaneous stimulation of the cervical vagus trunk. In addition, retching and emesis occur with stimulation of a fine nerve bundle dissected from the cervical vagus trunk. That the afferent pathway inhibitory to retching and emesis involves pulmonary afferents is suggested by the observation that hyperventilation occurs with stimulation of the cervical vagus trunk.Research supported by U.S.P.H.S. Grant No. FR05339-07