Review ArticleAcupuncture in the Treatment of Heart FailureMiddlekauff, Holly R. MDAuthor Information From the University of California–Los Angeles School of Medicine, Los Angeles, California. Reprints: Holly R. Middlekauff, MD, UCLA School of Medicine, Division of Cardiology, 47–123 CHS, 10833 LeConte Avenue, Los Angeles, CA 90095. Cardiology in Review: May-June 2004 - Volume 12 - Issue 3 - p 171-173 doi: 10.1097/01.crd.0000103650.71735.f0 Buy Metrics Abstract Few clinical studies evaluating the efficacy of acupuncture in heart failure have been performed. These studies have focused on the acupoint Neiguan (P6) in patients experiencing heart failure and have variably reported either an acute increase in ventricular contractility and/or relaxation or no effect on ventricular contractility and/or relaxation. To date, clinical studies have been hampered by small enrollment, inadequate controls, and unblinded design. Recent scientific studies of animal models of acupuncture support the concept that acupuncture produces release of endogenous opioids in the central nervous system, which in turn could inhibit central sympathetic outflow. Patients experiencing heart failure have markedly elevated sympathetic activity, and those with the greatest sympathetic activation have the worst survival. Preliminary data from our laboratory suggests that acupuncture could be sympatholytic in heart failure. We found that sympathetic activation during acute mental stress was virtually eliminated after acupuncture. More studies defining the efficacy of acupuncture, and its mechanisms, in the treatment of heart failure are warranted. © 2004 Lippincott Williams & Wilkins, Inc.