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Brain & Heart Autonomic nerve and heart failure

heart failure . Moreover, renal nerves have been found to an alternative medical treatment worldwide. Acupuncture
[84]
be involved in the newly identified intrinsic mechanism as a treatment strategy is extensively acknowledged
responsible for degrading cardioprotective natriuretic and commonly implemented in the United States [96,97] .
peptides (NPs). Furthermore, in individuals suffering Acupuncture has proven to be an effective treatment
from heart failure, abolishing the influence of renal for post-operative pain, as well as nausea and vomiting
nerves on renal function can lead to a decrease in renal resulting from chemotherapy and surgery. Apart from
neprilysin activity, an elevation in circulating NP levels, a the aforementioned uses, acupuncture has demonstrated
decrease in myocardial fibrosis, and an improvement in clinical effectiveness in addressing a myriad of other
the left ventricular function . However, controlling the ailments, such as drug dependence, bronchial asthma,
[85]
extent and effect of the current ablation methods on renal phlogosis, and pain. The stimulation of Neiguan and Jianshi
sympathetic nerve damage is challenging, and the clinical acupoints has exhibited notable efficacy and is commonly
efficacy has been controversial. favored over other acupoints utilized in the treatment of
cardiovascular diseases [98-100] . Research demonstrates that
4.2.2. Left stellate ganglion (LSG) ablation EA applied to the Neiguan and Jianshi acupoints can
The stellate ganglion (SG) neurons play a crucial role inhibit cardiovascular sympathetic excitatory pressure-
in regulating cardiac function as a major component reflex responses resulting from chemical, mechanical, and
of the autonomic nervous system. Prior research has electrical stimulation [101-104] . Stimulating the median nerve
demonstrated that heart failure can lead to an elevation in at the Neiguan acupoint through EA has been observed to
SG neural activity and result in remodeling of the cardiac decrease regional myocardial ischemia in cats with partial
ganglion [86,87] . In heart failure patients, sympathectomy coronary occlusion. This effect is achieved by decreasing
and SG block are viable treatment options for managing sympathetic-mediated cardiac oxygen demand, thereby
ventricular arrhythmias and cardiac insufficiency with preventing the onset of ischemia [102] . The findings from
proven effectiveness [88-90] . To decrease the noradrenergic both clinical and animal studies imply that acupuncture
drive of the heart, targeted ablation of cardiac sympathetic could be advantageous in managing and regulating certain
neurons (TACSN) serves as an efficient method, achieved forms of hypertension, as well as cardiac arrhythmias
through retrograde administration of cholera toxin and coronary heart disease [99,100,105,106] . In rats, EA has
B-saporin (CTB-SAP) compounds into the SG . Research been observed to lower sympathetic activity [107,108] and
[91]
has indicated that CTB-SAP is able to effectively and markedly reduce cardiovascular sympathetic excitatory
selectively eliminate cardiac sympathetic preganglionic reflex responses following chemical, mechanical, and
neurons by binding with GM1 ganglioside, which is present electrical stimulation [101-104] . EA applied to the median
on the plasma membrane of these neurons. Consequently, nerve at the Neiguan and Jianshi acupoints is particularly
there is a decrease in the population of post-ganglionic efficacious in mitigating the pressure response arising
neurons within the SG and sympathetic innervation from cardiovascular sympathetic excitatory reflexes [99,100] .
of the ventricular myocardium, effectively hindering EA shows promise as a potentially valuable approach to
sympathetic activation triggered by reflex and exercise, managing various disease categories. While one study
as demonstrated in conscious rats [92,93] . LSG ablation on animals [109] has demonstrated the efficacy of EA as a
effectively inhibits cardiac sympathetic nerve activity, but supplementary or alternate form of therapy, its mechanisms
the nerves and blood vessels that are abundant in the neck are not yet well understood. Therefore, more extensive
are vulnerable to damage when the SG is isolated. LSG studies involving more study subjects are necessary to
ablation also has an impact on sinus node function and investigate its clinical efficacy and associated underlying
may not completely prevent the development of Horner’s mechanisms.
syndrome. For these reasons, LSG ablation has not been
widely adopted in clinical settings [94,95] . On the other hand, 5. Conclusion
the right SG ablation might contribute to the onset of In recent years, an increasing number of animal studies
ventricular arrhythmias [94,95] . and clinical data have indicated the potential of non-
pharmacological methods, such as EA, renal sympathetic
4.3. Acupuncture therapy nerve ablation, BAT, and VNS, to inhibit sympathetic
Acupuncture, a component of traditional Chinese nerve activity and stimulate vagal excitation in the course
medicine, has been utilized as a therapeutic option for of cardiac remodeling and the treatment of heart failure.
treating a wide range of diseases and disorders for over a Identifying the intervention targets with fewer side effects,
millennium. Electro-acupuncture (EA), a stronger variation more precise efficacy, higher safety, better specificity, and
of acupuncture, is also prevalent and has been adopted as more feasible operation and finding new ideas for the

Volume 1 Issue 2 (2023) 7 https://doi.org/10.36922/bh.0913