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Case report: SGLT2i, transcutaneous vagus nerve stimulation, and their effects on intrarenal venous flow pattern in HFpEF

Renal congestion in heart failure (HF) is a predictor of the prognosis of cardiovascular disease. The effect of sodium-glucose cotransporter 2 inhibitors (SGLT2i) and vagus nerve stimulation (VNS) on renal congestion has not been reported in HF. A 77-year-old man with HF with preserved ejection frac...

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Autores principales: Nagai, Michiaki, Dote, Keigo, Kato, Masaya, Sasaki, Shota, Oda, Noboru, Förster, Carola Y.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9523255/
https://www.ncbi.nlm.nih.gov/pubmed/36188455
http://dx.doi.org/10.3389/fnins.2022.999831
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author Nagai, Michiaki
Dote, Keigo
Kato, Masaya
Sasaki, Shota
Oda, Noboru
Förster, Carola Y.
author_facet Nagai, Michiaki
Dote, Keigo
Kato, Masaya
Sasaki, Shota
Oda, Noboru
Förster, Carola Y.
author_sort Nagai, Michiaki
collection PubMed
description Renal congestion in heart failure (HF) is a predictor of the prognosis of cardiovascular disease. The effect of sodium-glucose cotransporter 2 inhibitors (SGLT2i) and vagus nerve stimulation (VNS) on renal congestion has not been reported in HF. A 77-year-old man with HF with preserved ejection fraction (HFpEF) was referred to our hospital because of poor response to loop diuretics. Echocardiography showed severe tricuspid regurgitation with dilation of the right atrium. Three months after adding SGLT2i, body weight was lost without worsening of renal function. Left and right doppler-derived intrarenal venous flow (IRVF) has been changed from a monophasic to a discontinuous pattern with a systolic interruption. One month later, he discontinued SGLT2i administration at his own discretion. In order to stabilizing autonomic balance, transcutaneous VNS (tVNS) was performed via left ear tragus. One hour after transcutaneous tVNS, ipsilateral IRVF has been dramatically improved from a fusional biphasic to a discontinuous pattern with a systolic interruption. SGLT2i and tVNS may be associated with renal decongestion in HFpEF.
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spelling pubmed-95232552022-10-01 Case report: SGLT2i, transcutaneous vagus nerve stimulation, and their effects on intrarenal venous flow pattern in HFpEF Nagai, Michiaki Dote, Keigo Kato, Masaya Sasaki, Shota Oda, Noboru Förster, Carola Y. Front Neurosci Neuroscience Renal congestion in heart failure (HF) is a predictor of the prognosis of cardiovascular disease. The effect of sodium-glucose cotransporter 2 inhibitors (SGLT2i) and vagus nerve stimulation (VNS) on renal congestion has not been reported in HF. A 77-year-old man with HF with preserved ejection fraction (HFpEF) was referred to our hospital because of poor response to loop diuretics. Echocardiography showed severe tricuspid regurgitation with dilation of the right atrium. Three months after adding SGLT2i, body weight was lost without worsening of renal function. Left and right doppler-derived intrarenal venous flow (IRVF) has been changed from a monophasic to a discontinuous pattern with a systolic interruption. One month later, he discontinued SGLT2i administration at his own discretion. In order to stabilizing autonomic balance, transcutaneous VNS (tVNS) was performed via left ear tragus. One hour after transcutaneous tVNS, ipsilateral IRVF has been dramatically improved from a fusional biphasic to a discontinuous pattern with a systolic interruption. SGLT2i and tVNS may be associated with renal decongestion in HFpEF. Frontiers Media S.A. 2022-09-16 /pmc/articles/PMC9523255/ /pubmed/36188455 http://dx.doi.org/10.3389/fnins.2022.999831 Text en Copyright © 2022 Nagai, Dote, Kato, Sasaki, Oda and Förster. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Neuroscience
Nagai, Michiaki
Dote, Keigo
Kato, Masaya
Sasaki, Shota
Oda, Noboru
Förster, Carola Y.
Case report: SGLT2i, transcutaneous vagus nerve stimulation, and their effects on intrarenal venous flow pattern in HFpEF
title Case report: SGLT2i, transcutaneous vagus nerve stimulation, and their effects on intrarenal venous flow pattern in HFpEF
title_full Case report: SGLT2i, transcutaneous vagus nerve stimulation, and their effects on intrarenal venous flow pattern in HFpEF
title_fullStr Case report: SGLT2i, transcutaneous vagus nerve stimulation, and their effects on intrarenal venous flow pattern in HFpEF
title_full_unstemmed Case report: SGLT2i, transcutaneous vagus nerve stimulation, and their effects on intrarenal venous flow pattern in HFpEF
title_short Case report: SGLT2i, transcutaneous vagus nerve stimulation, and their effects on intrarenal venous flow pattern in HFpEF
title_sort case report: sglt2i, transcutaneous vagus nerve stimulation, and their effects on intrarenal venous flow pattern in hfpef
topic Neuroscience
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9523255/
https://www.ncbi.nlm.nih.gov/pubmed/36188455
http://dx.doi.org/10.3389/fnins.2022.999831
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