Acupuncture on Cardiac and Autonomic Function in Human Heart Failure
Status: | Active, not recruiting |
---|---|
Conditions: | Cardiology |
Therapuetic Areas: | Cardiology / Vascular Diseases |
Healthy: | No |
Age Range: | 21 - Any |
Updated: | 3/31/2019 |
Start Date: | February 2013 |
End Date: | December 2019 |
Acupuncture treatment may improve the cardiac function and the quality of life in heart
failure patients. These effects may be related to the inhibition of sympathetic activity
and/or increased vagal function. The suppression of inflammatory reaction with acupuncture
treatment may also be associated with these outcomes. Specific aims include:
1. To evaluate the effect of acupuncture treatment on human cardiac sympathetic/vagal
activity
2. To evaluate the effect of acupuncture treatment on cardiac function and functional
capacity
3. To evaluate the general health score of the quality-of-life with acupuncture treatment
4. To explore the mechanism of acupuncture treatment on inflammation and nitrative stress
in heart failure patients.
failure patients. These effects may be related to the inhibition of sympathetic activity
and/or increased vagal function. The suppression of inflammatory reaction with acupuncture
treatment may also be associated with these outcomes. Specific aims include:
1. To evaluate the effect of acupuncture treatment on human cardiac sympathetic/vagal
activity
2. To evaluate the effect of acupuncture treatment on cardiac function and functional
capacity
3. To evaluate the general health score of the quality-of-life with acupuncture treatment
4. To explore the mechanism of acupuncture treatment on inflammation and nitrative stress
in heart failure patients.
The primary aim of this study is to evaluate the effect of acupuncture treatment on cardiac
sympathetic/vagal activity in chronic heart failure patients. The investigators would like to
investigate the effect of acupuncture treatment on cardiac function and the general health
score of the quality-of-life. The investigators would like to further explore the mechanism
of acupuncture treatment on autonomic imbalance and chronic inflammatory reaction in heart
failure patients by comparing the treatment and sham groups, the baseline before the
treatment and the changes after treatment.
Chronic heart failure affects millions people and is a leading cause of death in US. Despite
of advance in diagnoses and treatments, the long-term prognosis and quality of life of
chronic heart failure patients remain poor. The mortality of chronic heart failure is
estimated 50% within 4 years, and is more than 50% in patients with severe chronic heart
failure.
Chronic heart failure results from the left ventricular (LV) systolic and/or diastolic
dysfunction. Autonomic imbalance with sustained sympathetic overdrive and vagal withdrawal
plays an important role in the development of chronic heart failure. This autonomic
dysregulation is related to increased heart rate, excess inflammatory response, progressive
LV dysfunction, increased mortality and morbidity in chronic heart failure patients.
Sympathetic active inhibition with beta-adrenergic receptor blockers has shown significant
reduction in mortality and morbidity in chronic heart failure patients. Also modulation of
parasympathetic activation with electrical vagus nerve stimulation (VNS) has demonstrated as
a potential therapy for chronic heart failure.
Acupuncture has been widely used in China for thousands of years to treat a variety of
diseases and their symptoms. Except pain disorders, increasing evidences have shown that
acupuncture may be useful for cardiovascular diseases, such as coronary artery disease,
hypertension and chronic heart failure. It has been demonstrated that certain acupuncture
points have shown to inhibit cardiac sympathetic activation or increase cardiac vagal
component in both experimental animals and clinical studies. Recently a small clinical trial
by Dr. Kristen, et al has found that acupuncture could improve exercise tolerance in chronic
heart failure patients.
The investigators hypothesize that acupuncture treatment may improve the cardiac function and
the quality of life in heart failure patients. These effects may be related to the inhibition
of sympathetic activity and/or increased vagal function. The suppression of inflammatory
reaction with acupuncture treatment may also be associated with these outcomes. In addition
to optimized standard heart failure medications, acupuncture may be a safe therapeutic
strategy in chronic heart failure treatment. Studies of acupuncture on cardiac autonomic
activity in heart failure may show more evidence of acupuncture treatment in chronic heart
failure patients.
sympathetic/vagal activity in chronic heart failure patients. The investigators would like to
investigate the effect of acupuncture treatment on cardiac function and the general health
score of the quality-of-life. The investigators would like to further explore the mechanism
of acupuncture treatment on autonomic imbalance and chronic inflammatory reaction in heart
failure patients by comparing the treatment and sham groups, the baseline before the
treatment and the changes after treatment.
Chronic heart failure affects millions people and is a leading cause of death in US. Despite
of advance in diagnoses and treatments, the long-term prognosis and quality of life of
chronic heart failure patients remain poor. The mortality of chronic heart failure is
estimated 50% within 4 years, and is more than 50% in patients with severe chronic heart
failure.
Chronic heart failure results from the left ventricular (LV) systolic and/or diastolic
dysfunction. Autonomic imbalance with sustained sympathetic overdrive and vagal withdrawal
plays an important role in the development of chronic heart failure. This autonomic
dysregulation is related to increased heart rate, excess inflammatory response, progressive
LV dysfunction, increased mortality and morbidity in chronic heart failure patients.
Sympathetic active inhibition with beta-adrenergic receptor blockers has shown significant
reduction in mortality and morbidity in chronic heart failure patients. Also modulation of
parasympathetic activation with electrical vagus nerve stimulation (VNS) has demonstrated as
a potential therapy for chronic heart failure.
Acupuncture has been widely used in China for thousands of years to treat a variety of
diseases and their symptoms. Except pain disorders, increasing evidences have shown that
acupuncture may be useful for cardiovascular diseases, such as coronary artery disease,
hypertension and chronic heart failure. It has been demonstrated that certain acupuncture
points have shown to inhibit cardiac sympathetic activation or increase cardiac vagal
component in both experimental animals and clinical studies. Recently a small clinical trial
by Dr. Kristen, et al has found that acupuncture could improve exercise tolerance in chronic
heart failure patients.
The investigators hypothesize that acupuncture treatment may improve the cardiac function and
the quality of life in heart failure patients. These effects may be related to the inhibition
of sympathetic activity and/or increased vagal function. The suppression of inflammatory
reaction with acupuncture treatment may also be associated with these outcomes. In addition
to optimized standard heart failure medications, acupuncture may be a safe therapeutic
strategy in chronic heart failure treatment. Studies of acupuncture on cardiac autonomic
activity in heart failure may show more evidence of acupuncture treatment in chronic heart
failure patients.
Inclusion Criteria:
- Age ≥ 21 years
- Congestive Heart Failure (CHF), New York Heart Association (NYHA) class II-III, LVEF
≤40%
- All patients will have sinus rhythm and compensate with individually optimized
standard heart failure medications. Routine medications will be continued during the
study period
- Able and willing to give informed consent or comply with study procedures.
Exclusion Criteria:
- Acupuncture treatment within 3 months before the beginning of the study
- Presents with cutaneous eczema at potential acupoints
- Have a history of major bleeding or increased propensity of excessive bleeding due to
platelet dysfunction
- Currently taking anti-coagulants (e.g. warfarin)
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