Acupuncture and heart function

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Abstract 3499 (Poster)

American Heart Association meeting report:

 

Acupuncture calms nerves, improves heart function

 

ANAHEIM, Calif., Nov. 14 - Acupuncture improved the health prospects

of individuals with severe heart failure, according to an unique

study reported today at the American Heart Association's Scientific

Sessions 2001 conference.

 

Acupuncture - the practice of piercing the skin with needles at

specific points to treat illness or relieve pain - dramatically

reduced sympathetic nerve activity among heart failure patients. The

sympathetic nervous system regulates involuntary movements such as

heartbeat and blood pressure. Over-activation of sympathetic nerves

is common in heart failure patients and associated with a poor

prognosis because it forces the weakened heart to work harder and

predisposes the heart to potentially lethal heart rhythms.

 

" There is an ever-increasing interest in alternative medicine. But

until now, no one had looked at acupuncture's effect on the very

sickest heart failure patients. Our research represents a promising

first step, but more study is definitely needed, " says lead author

Holly R. Middlekauff, M.D., associate professor of medicine at the

University of California Los Angeles School of Medicine.

 

" Advanced heart failure patients often have two or three times more

sympathetic nerve activity than normal individuals, " she says. " It

has been shown that the greater this activity is, the worse the

outlook for the patient, so reducing it could be crucial. "

 

In the first controlled clinical trial of its kind, the researchers

divided 14 critically ill chronic heart failure patients referred

for heart transplantation evaluation into three groups. One group

received acupuncture at traditional acupuncture sites. The second

received " non-acupoint " acupuncture in which needles were placed at

sites not traditionally believed to be useful in acupuncture.

Finally, the third group had a " no-needle " simulation of the

treatment, in which a needle holder is tapped to the back of their

neck, but no needle was inserted.

 

The average age of the patients in the study was 43, and they

included both men and women.

 

Blood pressure, heart rate and sympathetic nerve activity were

measured in all the patients following a four-minute mental stress

test. Mental stress was produced by having participants perform math

problems in their heads and answer aloud, or by a color/word

conflict test. In the word test, names of colors are written in ink

different from the printed word. Participants must say the name of

the color, not read the word.

 

The acupuncture group took the stress test again, but this time

acupuncture needles were inserted and left in place for 20 minutes.

After the first test, sympathetic nerve activity increased by about

25 percent, as measured by electrodes placed on nerves near the

patients' knees, but there was no increase in this activity among

the acupuncture patients following the second stress test.

 

After undergoing identical mental stress tests, patients in the " no

needle " group were told that acupuncture needles were being inserted

in the backs of their necks. But no needles were actually used, and

no decrease in their sympathetic nerve activation during mental

stress occurred, which shows that there was no placebo effect

occurring, Middlekauff says. Similarly, in the non-acupoint group no

decrease in their sympathetic nerve activation during mental stress

occurred.

 

" Blood pressure and heart rate were unaffected by the acupuncture,

and both increased after mental stress testing in all groups, but

sympathetic nerve activation was significantly reduced in the

acupuncture group, " she says.

 

Thus, they conclude acupuncture can reduce sympathetic nerve

activity in individuals with chronic heart failure.

 

Middlekauff says further study is needed before acupuncture could be

recommend as a routine treatment for patients with severe heart

failure.

 

" We need to do more studies in large patient populations and repeat

the acupuncture procedures over a period of weeks, rather than just

once, as we did in our study, " she says. " But in clinical

experience, acupuncture has been used successfully and with long-

range results in improving hypertension, and it may also be

beneficial in lowering sympathetic nerve activity. "

 

Animal studies completed to date indicate that acupuncture works

best in the most extreme cases of sympathetic nerve elevation, but

the factors that cause nerve activity to increase are complex and

still under investigation, Middlekauff notes.

 

Other researchers participating in the study are: Jun Liang Yu;

Kakit Hui, M.D.; Michele Hamilton, M.D.; Gregg Fonarow, M.D.; Jaime

Moriguchi, M.D.; and Antoine Hage, M.D.