Relationship Between Regional Cardiac Hyperinnervation and Ventricular Arrhythmia

Author:

Cao Ji-Min1,Fishbein Michael C.1,Han Jay B.1,Lai William W.1,Lai Angela C.1,Wu Tsu-Juey1,Czer Lawrence1,Wolf Paul L.1,Denton Timothy A.1,Shintaku I. Peter1,Chen Peng-Sheng1,Chen Lan S.1

Affiliation:

1. From the Division of Cardiology (J.-M.C., J.B.H., W.W.L., A.C.L., T.-J.W., P.-S.C.), Department of Medicine, Division of Cardiothoracic Surgery (L.C., T.A.D.), Department of Surgery, Cedars-Sinai Medical Center and University of California Los Angeles School of Medicine; Department of Pathology (M.C.F., I.P.S.), University of California Los Angeles School of Medicine; Department of Pathology (P.L.W.), Veterans Affairs Medical Center and University of California San Diego; and Division of Neurology ...

Abstract

Background —Sympathetic nerve activity is known to be important in ventricular arrhythmogenesis, but there is little information on the relation between the distribution of cardiac sympathetic nerves and the occurrence of spontaneous ventricular arrhythmias in humans. Methods and Results —We studied 53 native hearts of transplant recipients, 5 hearts obtained at autopsy of patients who died of noncardiac causes, and 7 ventricular tissues that had been surgically resected from the origin of ventricular tachycardia. The history was reviewed to determine the presence (group 1A) or absence (group 1B) of spontaneous ventricular arrhythmias. Immunocytochemical staining for S100 protein, neurofilament protein, tyrosine hydroxylase, and protein gene product 9.5 was performed to study the distribution and the density of sympathetic nerves. The average left ventricular ejection fraction was 0.22±0.07. A total of 30 patients had documented ventricular arrhythmias, including ventricular tachycardia and sudden cardiac death. A regional increase in sympathetic nerves was observed around the diseased myocardium and blood vessels in all 30 hearts. The density of nerve fibers as determined morphometrically was significantly higher in group 1A patients (total nerve number 19.6±11.2/mm 2 , total nerve length 3.3±3.0 mm/mm 2 ) than in group 1B patients (total nerve number 13.5±6.1/mm 2 , total nerve length 2.0±1.1 mm/mm 2 , P <0.05 and P <0.01, respectively). Conclusions —There is an association between a history of spontaneous ventricular arrhythmia and an increased density of sympathetic nerves in patients with severe heart failure. These findings suggest that abnormally increased postinjury sympathetic nerve density may be in part responsible for the occurrence of ventricular arrhythmia and sudden cardiac death in these patients.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine

Cited by 403 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3