Pei Zhang1, Jin-Jun Liang2, Cheng Cai3, Ying Tian4, Ming-Yan Dai2, Johnson Wong5, Thomas H Everett5, Erica D Wittwer6, Gregory W Barsness7, Peng-Sheng Chen5, Chen-Yang Jiang8, Yong-Mei Cha9. 1. Department of Cardiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China; Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota. 2. Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota; Department of Cardiology, Renmin Hospital of Wuhan University, Wuhan, China. 3. Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota; Department of Cardiology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China. 4. Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota; Department of Cardiology, Beijing Chaoyang Hospital, Beijing, China. 5. The Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine, Indianapolis, Indiana. 6. Department of Intensive Care and Respiratory Therapy, Mayo Clinic, Rochester, Minnesota. 7. Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota. 8. Department of Cardiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China. 9. Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota. Electronic address: ycha@mayo.edu.
Abstract
BACKGROUND: Heightened sympathetic nerve activity is associated with occurrence of ventricular arrhythmia (VA). OBJECTIVE: To investigate the association of skin sympathetic nerve activity (SKNA) and VA occurrence. METHODS: We prospectively enrolled 65 patients with severe cardiomyopathy. Of these, 39 had recent sustained VA episodes (VA-1 group), 11 had intractable VA undergoing sedation with general anesthesia (VA-2 group), and 15 had no known history of VA (VA-Ctrl group). All patients had simultaneous SKNA and electrocardiogram recording. SKNA was assessed using an average value (aSKNA), a variable value (vSKNA), and the number of bursts of SKNA (bSKNA). RESULTS: The VA-1 group had higher aSKNA and vSKNA compared with the VA-Ctrl group (aSKNA: 1.41 ± 0.53 μV vs 0.98 ± 0.41 μV, P = .003; vSKNA: 0.52 ± 0.22 μV vs 0.30 ± 0.16 μV, P < .001) and the VA-2 group (aSKNA: 0.83 ± 0.22 μV, P < .001; vSKNA: 0.23 ± 0.11 μV; P < .001). Although the VA-2 group had more VA episodes than the VA-1 group (median, 5 vs 2; P = .01), their SKNA was the lowest among the 3 groups. Multivariate Cox regression analysis showed that a higher aSKNA at baseline was an independent predictor of lower VA recurrence rate during a 417 ± 279-day follow-up (hazard ratio, 0.325; 95% confidence interval [CI], 0.119-0.883; P = .03). A >15% reduction in aSKNA after therapy was associated with a lower subsequent VA event rate (hazard ratio, 0.222; 95% CI, 0.057-0.864; P = .03). CONCLUSION: Patients with VA had increased SKNA as compared with control. Both SKNA and sustained VA could be suppressed by general anesthesia. The aSKNA at baseline was an independent predictor of VA recurrence.
BACKGROUND: Heightened sympathetic nerve activity is associated with occurrence of ventricular arrhythmia (VA). OBJECTIVE: To investigate the association of skin sympathetic nerve activity (SKNA) and VA occurrence. METHODS: We prospectively enrolled 65 patients with severe cardiomyopathy. Of these, 39 had recent sustained VA episodes (VA-1 group), 11 had intractable VA undergoing sedation with general anesthesia (VA-2 group), and 15 had no known history of VA (VA-Ctrl group). All patients had simultaneous SKNA and electrocardiogram recording. SKNA was assessed using an average value (aSKNA), a variable value (vSKNA), and the number of bursts of SKNA (bSKNA). RESULTS: The VA-1 group had higher aSKNA and vSKNA compared with the VA-Ctrl group (aSKNA: 1.41 ± 0.53 μV vs 0.98 ± 0.41 μV, P = .003; vSKNA: 0.52 ± 0.22 μV vs 0.30 ± 0.16 μV, P < .001) and the VA-2 group (aSKNA: 0.83 ± 0.22 μV, P < .001; vSKNA: 0.23 ± 0.11 μV; P < .001). Although the VA-2 group had more VA episodes than the VA-1 group (median, 5 vs 2; P = .01), their SKNA was the lowest among the 3 groups. Multivariate Cox regression analysis showed that a higher aSKNA at baseline was an independent predictor of lower VA recurrence rate during a 417 ± 279-day follow-up (hazard ratio, 0.325; 95% confidence interval [CI], 0.119-0.883; P = .03). A >15% reduction in aSKNA after therapy was associated with a lower subsequent VA event rate (hazard ratio, 0.222; 95% CI, 0.057-0.864; P = .03). CONCLUSION:Patients with VA had increased SKNA as compared with control. Both SKNA and sustained VA could be suppressed by general anesthesia. The aSKNA at baseline was an independent predictor of VA recurrence.
Authors: Songwen Chen; Guannan Meng; Anisiia Doytchinova; Johnson Wong; Susan Straka; Julie Lacy; Xiaochun Li; Peng-Sheng Chen; Thomas H Everett Iv Journal: Front Physiol Date: 2021-12-22 Impact factor: 4.566