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The effect of low frequency neuromuscular stimulation on sympathetic activity in ‎advanced heart failure‎

Donia M Elmasry, Nesreen G. Elnahas, Hazem Khorshid, Awny F Rahmy


Aim of the study: The study was designed to determine the effect of low-frequency neuromuscular stimulation on sympathetic activity in advanced heart failure. Patients and methods: In this study, thirty patients with advanced heart failure (NYHA class IV) and mean± SD age of 56.13±1.13 years were included. They received 8 weeks (4 times/week) of increasing amplitude low-frequency neuromuscular stimulation on calf and quadriceps muscles after a thorough assessment of ejection fraction, Norepinephrine levels, 6-min walk test, and assessment of disability via Minnesota Living with Heart Failure Questionnaire. Results: Statistically significant decline was observed in sympathetic activity by Norepinephrine levels associated with decreased disability, with an improvement in ejection fraction, the change percentage in ejection fraction was 3.64% (p=0.018), with a decline in norepinephrine by a change percentage of -9.28% (p<0.001), associated with an improvement in six-minute walking test by a percentage of 22.97% (p<0.001) and improved psychological, emotional, and functional status of the patients with a decline of Minnesota Living with Heart Failure Questionnaire score by -24.06% (p<0.001). Conclusion: Low-frequency neuromuscular stimulation altered sympathetic activity leading to higher functional levels.

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