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

Abstract

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.