Researchers at Almazov Centre put forward a new scientific hypothesis about the influence of age-related changes in the activity of the autonomic nervous system and the innervation of internal organs as a determining factor in the effectiveness of neuromodulation methods in the treatment of cardiovascular diseases.
In recent years, methods that involve the modulation of the autonomic nervous system have been rapidly developed in cardiology for the treatment of a number of chronic diseases – systemic arterial and pulmonary hypertension, atrial fibrillation and ventricular arrhythmias, coronary artery disease, heart failure, arterial hypotension, and some others. Methods such as renal artery denervation, pulmonary artery denervation, sympathetic cardiac denervation, invasive and non-invasive spinal cord stimulation, carotid baroreceptor stimulation, and a number of others have been investigated in clinical studies. However, the positive effects of neuromodulation are not always reproduced in new scientific works.
Researchers at the Neuromodulation Research Laboratory of the Institute of Heart and Vessels conducted a systematic analysis of clinical research in this area. It turned out that the patient’s age is one of the most underestimated factors in determining the results of the therapeutic effects of neuromodulation.
It is assumed that in younger patients, the effects of neuromodulation may be more pronounced. In other words, at earlier stages of the disease, methods that involve the modulation of the autonomic nervous system seem to be the most promising. In old age, weaker parasympathetic reactions and a lower overall activity of the internal neural regulation are often noted. Therefore, the less autonomic neural regulation is involved in the pathophysiology of the disease, the less effect of neuromodulation should be expected.
The study was conducted as part of the project «Development of new neuromodulation-based technologies for heart failure prevention and treatment» (grant of the Ministry of Education and Science, Agreement No. 075-15-2020-800). The results will be published in the Journal of Geriatric Cardiology (Mikhaylov EN, Gasimova NZ, Belyaeva NN, Condori Leandro HI, Vakhrushev AD, Shlyakhto EV. Device-based neuromodulation for cardiovascular diseases and patient’s age. Journal of geriatric cardiology 2022). Link to a preprint of the article.