Spontaneous stellate ganglion nerve activity and ventricular arrhythmia in a canine model of sudden death
Spontaneous stellate ganglion nerve activity and ventricular arrhythmia in a canine model of sudden death
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DOI：
10.1016/j.hrthm.2007.09.007
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发表时间：
2008-01-01
期刊：
影响因子：
5.5
通讯作者：
Chen, Lan S.
中科院分区：
文献类型：
--
作者：
Zhou, Shengmei;Jung, Byung-Chun;Chen, Lan S.
背景：关于动态动物瞬时交感神经活动与室性心律失常之间的时间关系的信息很少。目的：本研究的目的是确定交感神经活动增加是否先于室性心律失常的发作。方法采用神经生长因子输注左星状神经节（LSG）、房室传导阻滞、心肌梗死犬8只（实验组）和正常犬6只（对照组），同时连续记录左星状神经节（LSG）神经活动和心电图。结果LSG神经活动包括低幅脉冲放电活动（LABDA）和高幅脉冲放电活动（HASDA）。LABDA和HASDA都能加速心率。在实验组中，大多数室性心动过速（86.3%）和心源性猝死在15秒内进行LABDA或HASDA。离室性心动过速发作越近，神经活动越高。大多数HASDA患者立即发生室性心律失常（21%）或QRS形态学改变（65%）。HASDA以昼夜节律模式发生。实验组发生HASDA的频率是对照组的两倍。LSG电刺激增加了复极化的跨壁异质性（峰端间隔），并在实验组引起室性心动过速或纤颤，但在对照组没有。免疫组化研究显示实验组大鼠LSG突触发生和神经发芽增加。结论活动犬LSG存在两种不同类型的LSG神经活动（HASDA和LABDA）。大多数恶性室性心律失常之前均行HASDA或LABDA，其中HASDA尤其致心律失常。
BACKGROUND Little information is available on the temporal relationship between instantaneous sympathetic nerve activity and ventricular arrhythmia in ambulatory animals.OBJECTIVE The purpose of this study was to determine if increased sympathetic nerve activity precedes the onset of ventricular arrhythmia.METHODS Simultaneous continuous tong-term recording of left stellate ganglion (LSG) nerve activity and electrocardiography was performed in eight dogs with nerve growth factor infusion to the LSG, atrioventricular block, and myocardial infarction (experimental group) and in six normal dogs (control group).RESULTS LSG nerve activity included tow-amplitude burst discharge activity (LABDA) and high-amplitude spike discharge activity (HASDA). Both LABDA and HASDA accelerated heart rate. In the experimental group, most ventricular tachycardia (86.3%) and sudden cardiac death were preceded within 15 seconds by either LABDA or HASDA. The closer to onset of ventricular tachycardia, the higher the nerve activity. The majority of HASDA was followed immediately by either ventricular arrhythmia (21%) or QRS morphology changes (65%). HASDA occurred in a circadian pattern. HASDA occurred twice as often in the experimental group than in the control group. Electrical stimulation of LSG increased transmural heterogeneity of repolarization (Tpeak-end intervals) and induced either ventricular tachycardia or fibrillation in the experimental group but not in the control group. Immunohistochemical studies revealed increased synaptogenesis and nerve sprouting in the LSG in the experimental group.CONCLUSION Two distinct types of LSG nerve activity (HASDA and LABDA) are present in the LSG of ambulatory dogs. The majority of malignant ventricular arrhythmias are preceded by either HASDA or LABDA, with HASDA particularly arrhythmogenic.