Left stellate ganglion and vagal nerve activity and cardiac arrhythmias in ambulatory dogs with pacing-induced congestive heart failure
Left stellate ganglion and vagal nerve activity and cardiac arrhythmias in ambulatory dogs with pacing-induced congestive heart failure
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DOI：
10.1016/j.jacc.2007.03.045
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发表时间：
2007-07-24
影响因子：
24
通讯作者：
Chen, Peng-Sheng
中科院分区：
文献类型：
--
作者：
Ogawa, Masahiro;Zhou, Shengmei;Chen, Peng-Sheng
目的本研究的目的是确定自主神经活动模式在充血性心力衰竭（CHF）。背景自主神经活动与CHF患者心律失常之间的关系尚不清楚。方法在6只狗体内植入无线电发射机，连续（24/7）同时监测左星状神经节神经活动（SGNA）、迷走神经活动（VNA）和起搏诱导CHF前后的心电图。结果充血性心力衰竭使SGNA和VNA升高。SGNA而非VNA表现出昼夜变化模式。广泛的窦结纤维化。我们分析了2263次延长（> 3 s）的窦性暂停（PSP）和1420次长（> 10 s）的阵发性房性心动过速（PAT）。大多数（95.3%）PSP发作发生在夜间，56%的发作前有短暂的SGNA爆发，引起短暂性窦性心动过速。长时间的PAT发作通常（83%）是由SGNA和VNA同时放电引起的，然后是VNA戒断。室性早搏和室性心动过速发生在SGNA升高之前。结论夜间活动犬交感迷走神经平衡的降低是由于交感神经放电的减少而非迷走神经放电的净增加。慢性心力衰竭的过速综合征可能是由间歇性短脉冲SGNA引起的过速和窦房结抑制引起的。同时交感迷走神经放电是长时间PAT发作的原因。这些数据表明，在心力衰竭时自主神经放电的特定模式与心律失常之间存在关联。[J]中华医学会心脏科杂志2007；50:335-43 . [c] 2007。
Objectives The purpose of this study was to determine the patterns of autonomic nerve activity in congestive heart failure (CHF).Background The relationship between autonomic nerve activity and cardiac arrhythmias in CHF is unclear.Methods We implanted radiotransmitters in 6 dogs for continuous (24/7) simultaneous monitoring of left stellate ganglion nerve activity (SGNA), vagal nerve activity (VNA), and electrocardiography before and after pacing induced CHF.Results Congestive heart failure increased both SGNA and VNA. The SGNA but not VNA manifested a circadian variation pattern. There was extensive sinus node fibrosis. We analyzed 2,263 episodes of prolonged (> 3 s) sinus pauses (PSP) and 1,420 long (> 10 s) episodes of paroxysmal atrial tachycardia (PAT). Most (95.3%) PSP episodes occurred at night, and 56% were preceded by a short burst of SGNA that induced transient sinus tachycardia. Long PAT episodes were typically (83%) induced by simultaneous SGNA and VNA discharge, followed by VNA withdrawal. Premature ventricular contractions and ventricular tachycardia were preceded by elevated SGNA.Conclusions The reduction of sympathovagal balance at night in ambulatory dogs was due to reduced sympathetic discharge rather than a net increase of vagal discharge. The tachybrady syndrome in CHF might be triggered by an intermittent short burst of SGNA that resulted in tachycardia and sinus node suppression. Simultaneous sympathovagal discharge is a cause of long PAT episodes. These data indicate that there is an association between the specific patterns of autonomic nerve discharges and cardiac arrhythmia during CHF. (J Am Coll Cardiol 2007;50: 335-43) (c) 2007 by the American College of Cardiology Foundation.