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Tendulkar M, Tendulkar R, Dhanda PS, Yadav A, Jain M, Kaushik P. Clinical potential of sensory neurites in the heart and their role in decision-making. Front Neurosci 2024; 17:1308232. [PMID: 38415053 PMCID: PMC10896837 DOI: 10.3389/fnins.2023.1308232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 11/29/2023] [Indexed: 02/29/2024] Open
Abstract
The process of decision-making is quite complex involving different aspects of logic, emotion, and intuition. The process of decision-making can be summarized as choosing the best alternative among a given plethora of options in order to achieve the desired outcome. This requires establishing numerous neural networks between various factors associated with the decision and creation of possible combinations and speculating their possible outcomes. In a nutshell, it is a highly coordinated process consuming the majority of the brain's energy. It has been found that the heart comprises an intrinsic neural system that contributes not only to the decision-making process but also the short-term and long-term memory. There are approximately 40,000 cells present in the heart known as sensory neurites which play a vital role in memory transfer. The heart is quite a mysterious organ, which functions as a blood-pumping machine and an endocrine gland, as well as possesses a nervous system. There are multiple factors that affect this heart ecosystem, and they directly affect our decision-making capabilities. These interlinked relationships hint toward the sensory neurites which modulate cognition and mood regulation. This review article aims to provide deeper insights into the various roles played by sensory neurites in decision-making and other cognitive functions. The article highlights the pivotal role of sensory neurites in the numerous brain functions, and it also meticulously discusses the mechanisms through which they modulate their effects.
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Affiliation(s)
- Mugdha Tendulkar
- K. J. Somaiya Medical College and Research Centre, Mumbai, India
| | - Reshma Tendulkar
- Vivekanand Education Society's College of Pharmacy, Mumbai, India
| | | | - Alpa Yadav
- Department of Botany, Indira Gandhi University, Rewari, India
| | - Mukul Jain
- Cell and Developmental Biology Lab, Center of Research for Development, Parul University, Vadodara, India
- Department of Life Sciences, Parul Institute of Applied Sciences, Parul University, Vadodara, India
| | - Prashant Kaushik
- Chaudhary Charan Singh Haryana Agricultural University, Hisar, India
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2
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van Weperen VYH, Ripplinger CM, Vaseghi M. Autonomic control of ventricular function in health and disease: current state of the art. Clin Auton Res 2023; 33:491-517. [PMID: 37166736 PMCID: PMC10173946 DOI: 10.1007/s10286-023-00948-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Accepted: 04/20/2023] [Indexed: 05/12/2023]
Abstract
PURPOSE Cardiac autonomic dysfunction is one of the main pillars of cardiovascular pathophysiology. The purpose of this review is to provide an overview of the current state of the art on the pathological remodeling that occurs within the autonomic nervous system with cardiac injury and available neuromodulatory therapies for autonomic dysfunction in heart failure. METHODS Data from peer-reviewed publications on autonomic function in health and after cardiac injury are reviewed. The role of and evidence behind various neuromodulatory therapies both in preclinical investigation and in-use in clinical practice are summarized. RESULTS A harmonic interplay between the heart and the autonomic nervous system exists at multiple levels of the neuraxis. This interplay becomes disrupted in the setting of cardiovascular disease, resulting in pathological changes at multiple levels, from subcellular cardiac signaling of neurotransmitters to extra-cardiac, extra-thoracic remodeling. The subsequent detrimental cycle of sympathovagal imbalance, characterized by sympathoexcitation and parasympathetic withdrawal, predisposes to ventricular arrhythmias, progression of heart failure, and cardiac mortality. Knowledge on the etiology and pathophysiology of this condition has increased exponentially over the past few decades, resulting in a number of different neuromodulatory approaches. However, significant knowledge gaps in both sympathetic and parasympathetic interactions and causal factors that mediate progressive sympathoexcitation and parasympathetic dysfunction remain. CONCLUSIONS Although our understanding of autonomic imbalance in cardiovascular diseases has significantly increased, specific, pivotal mediators of this imbalance and the recognition and implementation of available autonomic parameters and neuromodulatory therapies are still lagging.
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Affiliation(s)
- Valerie Y H van Weperen
- Division of Cardiology, Department of Medicine, UCLA Cardiac Arrythmia Center, University of California, 100 Medical Plaza, Suite 660, Los Angeles, CA, 90095, USA
| | | | - Marmar Vaseghi
- Division of Cardiology, Department of Medicine, UCLA Cardiac Arrythmia Center, University of California, 100 Medical Plaza, Suite 660, Los Angeles, CA, 90095, USA.
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3
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Clyburn C, Li MH, Ingram SL, Andresen MC, Habecker BA. Cholinergic collaterals arising from noradrenergic sympathetic neurons in mice. J Physiol 2023; 601:1247-1264. [PMID: 36797985 PMCID: PMC10065914 DOI: 10.1113/jp284059] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 02/07/2023] [Indexed: 02/18/2023] Open
Abstract
The sympathetic nervous system vitally regulates autonomic functions, including cardiac activity. Postganglionic neurons of the sympathetic chain ganglia relay signals from the central nervous system to autonomic peripheral targets. Disrupting this flow of information often dysregulates organ function and leads to poor health outcomes. Despite the importance of these sympathetic neurons, fundamental aspects of the neurocircuitry within peripheral ganglia remain poorly understood. Conventionally, simple monosynaptic cholinergic pathways from preganglionic neurons are thought to activate postganglionic sympathetic neurons. However, early studies suggested more complex neurocircuits may be present within sympathetic ganglia. The present study recorded synaptic responses in sympathetic stellate ganglia neurons following electrical activation of the pre- and postganglionic nerve trunks and used genetic strategies to assess the presence of collateral projections between postganglionic neurons of the stellate ganglia. Orthograde activation of the preganglionic nerve trunk, T-2, uncovered high jitter synaptic latencies consistent with polysynaptic connections. Pharmacological inhibition of nicotinic acetylcholine receptors with hexamethonium blocked all synaptic events. To confirm that high jitter, polysynaptic events were due to the presence of cholinergic collaterals from postganglionic neurons within the stellate ganglion, we knocked out choline acetyltransferase in adult noradrenergic neurons. This genetic knockout eliminated orthograde high jitter synaptic events and EPSCs evoked by retrograde activation. These findings suggest that cholinergic collateral projections arise from noradrenergic neurons within sympathetic ganglia. Identifying the contributions of collateral excitation to normal physiology and pathophysiology is an important area of future study and may offer novel therapeutic targets for the treatment of autonomic imbalance. KEY POINTS: Electrical stimulation of a preganglionic nerve trunk evoked fast synaptic transmission in stellate ganglion neurons with low and high jitter latencies. Retrograde stimulation of a postganglionic nerve trunk evoked direct, all-or-none action currents and delayed nicotinic EPSCs indistinguishable from orthogradely-evoked EPSCs in stellate neurons. Nicotinic acetylcholine receptor blockade prevented all spontaneous and evoked synaptic activity. Knockout of acetylcholine production in noradrenergic neurons eliminated all retrogradely-evoked EPSCs but did not change retrograde action currents, indicating that noradrenergic neurons have cholinergic collaterals connecting neurons within the stellate ganglion.
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Affiliation(s)
- Courtney Clyburn
- Department of Chemical Physiology and Biochemistry, Oregon Health and Science University, Portland, OR, USA
| | - Ming-Hua Li
- Department of Chemical Physiology and Biochemistry, Oregon Health and Science University, Portland, OR, USA
| | - Susan L Ingram
- Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Michael C Andresen
- Department of Chemical Physiology and Biochemistry, Oregon Health and Science University, Portland, OR, USA
| | - Beth A Habecker
- Department of Chemical Physiology and Biochemistry, Oregon Health and Science University, Portland, OR, USA
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4
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Clyburn C, Andresen MC, Ingram SL, Habecker BA. Untangling Peripheral Sympathetic Neurocircuits. Front Cardiovasc Med 2022; 9:842656. [PMID: 35224065 PMCID: PMC8866570 DOI: 10.3389/fcvm.2022.842656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 01/19/2022] [Indexed: 11/13/2022] Open
Abstract
The sympathetic nervous system plays a critical role in regulating many autonomic functions, including cardiac rhythm. The postganglionic neurons in the sympathetic chain ganglia are essential components that relay sympathetic signals to target tissues and disruption of their activity leads to poor health outcomes. Despite this importance, the neurocircuitry within sympathetic ganglia is poorly understood. Canonically, postganglionic sympathetic neurons are thought to simply be activated by monosynaptic inputs from preganglionic cholinergic neurons of the intermediolateral cell columns of the spinal cord. Early electrophysiological studies of sympathetic ganglia where the peripheral nerve trunks were electrically stimulated identified excitatory cholinergic synaptic events in addition to retrograde action potentials, leading some to speculate that excitatory collateral projections are present. However, this seemed unlikely since sympathetic postganglionic neurons were known to synthesize and release norepinephrine and expression of dual neurochemical phenotypes had not been well recognized. In vitro studies clearly established the capacity of cultured sympathetic neurons to express and release acetylcholine and norepinephrine throughout development and even in pathophysiological conditions. Given this insight, we believe that the canonical view of ganglionic transmission needs to be reevaluated and may provide a mechanistic understanding of autonomic imbalance in disease. Further studies likely will require genetic models manipulating neurochemical phenotypes within sympathetic ganglia to resolve the function of cholinergic collateral projections between postganglionic neurons. In this perspective article, we will discuss the evidence for collateral projections in sympathetic ganglia, determine if current laboratory techniques could address these questions, and discuss potential obstacles and caveats.
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Affiliation(s)
- Courtney Clyburn
- Department of Chemical Physiology and Biochemistry, Oregon Health and Science University, Portland, OR, United States
| | - Michael C. Andresen
- Department of Chemical Physiology and Biochemistry, Oregon Health and Science University, Portland, OR, United States
| | - Susan L. Ingram
- Department of Neurological Surgery, Oregon Health and Science University, Portland, OR, United States
| | - Beth A. Habecker
- Department of Chemical Physiology and Biochemistry, Oregon Health and Science University, Portland, OR, United States
- *Correspondence: Beth A. Habecker
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5
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Sudarshan KB, Hori Y, Swid MA, Karavos AC, Wooten C, Armour JA, Kember G, Ajijola OA. A novel metric linking stellate ganglion neuronal population dynamics to cardiopulmonary physiology. Am J Physiol Heart Circ Physiol 2021; 321:H369-H381. [PMID: 34213390 DOI: 10.1152/ajpheart.00138.2021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Cardiopulmonary sympathetic control is exerted via stellate ganglia (SG); however, little is known about how neuronal firing patterns in the stellate ganglion relate to dynamic physiological function in the heart and lungs. We performed continuous extracellular recordings from SG neurons using multielectrode arrays in chloralose-anesthetized pigs (n = 6) for 8-9 h. Respiratory and left ventricular pressures (RP and LVP, respectively) and the electrocardiogram (ECG) were recorded concomitantly. Linkages between sampled spikes and LVP or RP were determined using a novel metric to evaluate specificity in neural activity for phases of the cardiac and pulmonary cycles during resting conditions and under various cardiopulmonary stressors. Firing frequency (mean 4.6 ± 1.2 Hz) varied spatially across the stellate ganglion, suggesting regional processing. The firing pattern of most neurons was synchronized with both cardiac (LVP) and pulmonary (RP) activity indicative of cardiopulmonary integration. Using the novel metric to determine cardiac phase specificity of neuronal activity, we found that spike density was highest during diastole and near-peak systole. This specificity was independent of the actual LVP or population firing frequency as revealed by perturbations to the LVP. The observed specificity was weaker for RP. Stellate ganglion neuronal populations exhibit cardiopulmonary integration and profound specificity toward the near-peak systolic phase of the cardiac cycle. This novel approach provides practically deployable tools to probe stellate ganglion function and its relationship to cardiopulmonary pathophysiology.NEW & NOTEWORTHY Activity of stellate ganglion neurons is often linking indirectly to cardiac function. Using novel approaches coupled with extended period of recordings in large animals, we link neuronal population dynamics to mechanical events occurring at near-peak systole. This metric can be deployed to probe stellate ganglion neuronal control of cardiopulmonary function in normal and disease states.
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Affiliation(s)
- Koustubh B Sudarshan
- Department of Engineering Mathematics and Internetworking, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Yuichi Hori
- Cardiac Arrhythmia Center and Neurocardiology Research Program, University of California, Los Angeles, California
| | - M Amer Swid
- Cardiac Arrhythmia Center and Neurocardiology Research Program, University of California, Los Angeles, California
| | - Alexander C Karavos
- Department of Engineering Mathematics and Internetworking, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Christian Wooten
- Cardiac Arrhythmia Center and Neurocardiology Research Program, University of California, Los Angeles, California
| | - J Andrew Armour
- Cardiac Arrhythmia Center and Neurocardiology Research Program, University of California, Los Angeles, California
| | - Guy Kember
- Department of Engineering Mathematics and Internetworking, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Olujimi A Ajijola
- Cardiac Arrhythmia Center and Neurocardiology Research Program, University of California, Los Angeles, California.,Molecular, Cellular, and Integrative Physiology Interdepartmental Program, University of California, Los Angeles, California
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6
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Manolis AA, Manolis TA, Apostolopoulos EJ, Apostolaki NE, Melita H, Manolis AS. The role of the autonomic nervous system in cardiac arrhythmias: The neuro-cardiac axis, more foe than friend? Trends Cardiovasc Med 2020; 31:290-302. [PMID: 32434043 DOI: 10.1016/j.tcm.2020.04.011] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 04/24/2020] [Accepted: 04/30/2020] [Indexed: 02/07/2023]
Abstract
The autonomic nervous system (ANS) with its two limbs, the sympathetic (SNS) and parasympathetic nervous system (PSNS), plays a critical role in the modulation of cardiac arrhythmogenesis. It can be both pro- and/or anti-arrhythmic at both the atrial and ventricular level of the myocardium. Intricate mechanisms, different for specific cardiac arrhythmias, are involved in this modulatory process. More data are available for the arrhythmogenic effects of the SNS, which, when overactive, can trigger atrial and/or ventricular "adrenergic" arrhythmias in susceptible individuals (e.g. in patients with paroxysmal atrial fibrillation-PAF, ventricular pre-excitation, specific channelopathies, ischemic heart disease or cardiomyopathies), while it can also negate the protective anti-arrhythmic drug effects. However, there is also evidence that PSNS overactivity may be responsible for triggering "vagotonic" arrhythmias (e.g. PAF, Brugada syndrome, idiopathic ventricular fibrillation). Thus, a fine balance is necessary to attain in these two limbs of the ANS in order to maintain eurhythmia, which is a difficult task to accomplish. Over the years, in addition to classical drug therapies, where beta-blockers prevail, several ANS-modulating interventions have been developed aiming at prevention and management of arrhythmias. Among them, techniques of cardiac sympathetic denervation, renal denervation, vagal stimulation, ganglionated plexi ablation and the newer experimental method of optogenetics have been employed. However, in many arrhythmogenic diseases, ANS modulation is still an investigative tool. Initial data are encouraging; however, further studies are needed to explore the efficacy of such interventions. These issues are herein reviewed and old and recent literature data are discussed, tabulated and pictorially illustrated.
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7
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Affiliation(s)
- Wilfrid Jänig
- Department of Physiology, Christian-Albrechts-Universität zu Kiel, Kiel, Germany
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8
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Yu L, Wang M, Hu D, Huang B, Zhou L, Zhou X, Wang Z, Wang S, Jiang H. Blocking the Nav1.8 channel in the left stellate ganglion suppresses ventricular arrhythmia induced by acute ischemia in a canine model. Sci Rep 2017; 7:534. [PMID: 28373696 PMCID: PMC5428783 DOI: 10.1038/s41598-017-00642-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 03/07/2017] [Indexed: 01/01/2023] Open
Abstract
Left stellate ganglion (LSG) hyperactivity promotes ischemia induced ventricular arrhythmia (VA). Blocking the Nav1.8 channel decreases neuron activity. Therefore, the present study aimed to investigate whether blocking the Nav1.8 channel with its specific blocker A-803467 in the LSG reduces sympathetic activity and exerts anti-arrhythmic effects. Forty canines were divided into dimethylsulfoxide (DMSO) group and 10 mM, 15 mM, and 20 mM A-803467 groups. A volume of 0.1 ml of A-803467 or DMSO was injected into the LSG. The ventricular electrophysiological parameters, LSG function were measured before and 30 min after the injection. VA was assessed for 60 min after ischemia and then LSG tissues were collected for molecular biological experiments. Compared with DMSO, concentration-dependent prolonged action potential duration and effective refractory period, decreased LSG function were identified after A-803467 treatment. Moreover, the severity of ischemia induced VA was decreased in A-803467 groups. Furthermore, decreased nerve growth factor, decreased c-fos and increased sympathetic neuron apoptosis were found in the LSG after A-803467 injection. In conclusion, blocking the Nav1.8 channel could significantly attenuate ischemia-induced VA, primarily by suppressing LSG activity.
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Affiliation(s)
- Lilei Yu
- Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute, Wuhan University, Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Menglong Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute, Wuhan University, Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Dan Hu
- Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute, Wuhan University, Hubei Key Laboratory of Cardiology, Wuhan, China.,Masonic Medical Research Laboratory, 2150 Bleecker Street, Utica, New York, 13501-1787, USA
| | - Bing Huang
- Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute, Wuhan University, Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Liping Zhou
- Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute, Wuhan University, Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Xiaoya Zhou
- Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute, Wuhan University, Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Zhuo Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute, Wuhan University, Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Songyun Wang
- Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute, Wuhan University, Hubei Key Laboratory of Cardiology, Wuhan, China
| | - Hong Jiang
- Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute, Wuhan University, Hubei Key Laboratory of Cardiology, Wuhan, China.
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9
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Abstract
Cardiac control is mediated via a series of reflex control networks involving somata in the (i) intrinsic cardiac ganglia (heart), (ii) intrathoracic extracardiac ganglia (stellate, middle cervical), (iii) superior cervical ganglia, (iv) spinal cord, (v) brainstem, and (vi) higher centers. Each of these processing centers contains afferent, efferent, and local circuit neurons, which interact locally and in an interdependent fashion with the other levels to coordinate regional cardiac electrical and mechanical indices on a beat-to-beat basis. This control system is optimized to respond to normal physiological stressors (standing, exercise, and temperature); however, it can be catastrophically disrupted by pathological events such as myocardial ischemia. In fact, it is now recognized that autonomic dysregulation is central to the evolution of heart failure and arrhythmias. Autonomic regulation therapy is an emerging modality in the management of acute and chronic cardiac pathologies. Neuromodulation-based approaches that target select nexus points of this hierarchy for cardiac control offer unique opportunities to positively affect therapeutic outcomes via improved efficacy of cardiovascular reflex control. As such, understanding the anatomical and physiological basis for such control is necessary to implement effectively novel neuromodulation therapies. © 2016 American Physiological Society. Compr Physiol 6:1635-1653, 2016.
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Affiliation(s)
- Jeffrey L Ardell
- Los Angeles (UCLA) Cardiac Arrhythmia Center, David Geffen School of Medicine, University of California, Los Angeles, California, USA.,UCLA Neurocardiology Research Center of Excellence, David Geffen School of Medicine, Los Angeles, California, USA
| | - John Andrew Armour
- Los Angeles (UCLA) Cardiac Arrhythmia Center, David Geffen School of Medicine, University of California, Los Angeles, California, USA.,UCLA Neurocardiology Research Center of Excellence, David Geffen School of Medicine, Los Angeles, California, USA
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10
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Shivkumar K, Ajijola OA, Anand I, Armour JA, Chen PS, Esler M, De Ferrari GM, Fishbein MC, Goldberger JJ, Harper RM, Joyner MJ, Khalsa SS, Kumar R, Lane R, Mahajan A, Po S, Schwartz PJ, Somers VK, Valderrabano M, Vaseghi M, Zipes DP. Clinical neurocardiology defining the value of neuroscience-based cardiovascular therapeutics. J Physiol 2016; 594:3911-54. [PMID: 27114333 PMCID: PMC4945719 DOI: 10.1113/jp271870] [Citation(s) in RCA: 212] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2016] [Accepted: 04/08/2016] [Indexed: 12/13/2022] Open
Abstract
The autonomic nervous system regulates all aspects of normal cardiac function, and is recognized to play a critical role in the pathophysiology of many cardiovascular diseases. As such, the value of neuroscience-based cardiovascular therapeutics is increasingly evident. This White Paper reviews the current state of understanding of human cardiac neuroanatomy, neurophysiology, pathophysiology in specific disease conditions, autonomic testing, risk stratification, and neuromodulatory strategies to mitigate the progression of cardiovascular diseases.
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Affiliation(s)
- Kalyanam Shivkumar
- UCLA Cardiac Arrhythmia Center and Neurocardiology Research Center of Excellence, Los Angeles, CA, USA
| | - Olujimi A Ajijola
- UCLA Cardiac Arrhythmia Center and Neurocardiology Research Center of Excellence, Los Angeles, CA, USA
| | - Inder Anand
- Department of Cardiology, University of Minnesota Medical School, Minneapolis, MN, USA
| | - J Andrew Armour
- UCLA Cardiac Arrhythmia Center and Neurocardiology Research Center of Excellence, Los Angeles, CA, USA
| | - Peng-Sheng Chen
- Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Murray Esler
- Baker IDI Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | | | - Michael C Fishbein
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA
| | - Jeffrey J Goldberger
- Division of Cardiology, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Ronald M Harper
- Department of Neurobiology and the Brain Research Institute, University of California, Los Angeles, CA, USA
| | - Michael J Joyner
- Division of Cardiovascular Diseases, Mayo Clinic and Mayo Foundation, Rochester, MN, USA
| | | | - Rajesh Kumar
- Departments of Anesthesiology and Radiological Sciences, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Richard Lane
- Department of Psychiatry, University of Arizona College of Medicine, Tucson, AZ, USA
| | - Aman Mahajan
- Department of Anesthesia, UCLA, Los Angeles, CA, USA
| | - Sunny Po
- Heart Rhythm Institute, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- University of Tulsa Oxley College of Health Sciences, Tulsa, OK, USA
| | - Peter J Schwartz
- Center for Cardiac Arrhythmias of Genetic Origin, IRCCS Instituto Auxologico Italiano, c/o Centro Diagnostico e di Ricerrca San Carlo, Milan, Italy
| | - Virend K Somers
- Division of Cardiovascular Diseases, Mayo Clinic and Mayo Foundation, Rochester, MN, USA
| | - Miguel Valderrabano
- Methodist DeBakey Heart and Vascular Center and Methodist Hospital Research Institute, Houston Methodist Hospital, Houston, TX, USA
| | - Marmar Vaseghi
- UCLA Cardiac Arrhythmia Center and Neurocardiology Research Center of Excellence, Los Angeles, CA, USA
| | - Douglas P Zipes
- Indiana University School of Medicine, Indianapolis, IN, USA
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11
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More evidence supporting unified theory of stellate ganglion block. Med Hypotheses 2013; 81:146. [DOI: 10.1016/j.mehy.2013.04.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Revised: 02/21/2013] [Accepted: 04/12/2013] [Indexed: 11/19/2022]
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12
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Abstract
It is hypothesized that the heart possesses a nervous system intrinsic to it that represents the final relay station for the co-ordination of regional cardiac indices. This 'little brain' on the heart is comprised of spatially distributed sensory (afferent), interconnecting (local circuit) and motor (adrenergic and cholinergic efferent) neurones that communicate with others in intrathoracic extracardiac ganglia, all under the tonic influence of central neuronal command and circulating catecholamines. Neurones residing from the level of the heart to the insular cortex form temporally dependent reflexes that control overlapping, spatially determined cardiac indices. The emergent properties that most of its components display depend primarily on sensory transduction of the cardiovascular milieu. It is further hypothesized that the stochastic nature of such neuronal interactions represents a stabilizing feature that matches cardiac output to normal corporal blood flow demands. Thus, with regard to cardiac disease states, one must consider not only cardiac myocyte dysfunction but also the fact that components within this neuroaxis may interact abnormally to alter myocyte function. This review emphasizes the stochastic behaviour displayed by most peripheral cardiac neurones, which appears to be a consequence of their predominant cardiac chemosensory inputs, as well as their complex functional interconnectivity. Despite our limited understanding of the whole, current data indicate that the emergent properties displayed by most neurones comprising the cardiac neuroaxis will have to be taken into consideration when contemplating the targeting of its individual components if predictable, long-term therapeutic benefits are to accrue.
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Affiliation(s)
- J A Armour
- Hôpital du Sacré-Coeur de Montréal, Research Center, 5400 Gouin Boulevard West, Montreal, QC H4J 1C5, Canada.
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13
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Abstract
Heart failure is characterized by an elevation in sympathetic tone. The mechanisms responsible for this sympatho-excitation of heart failure are not completely understood. Several studies from this laboratory have compared differences in the cardiac "sympathetic afferent" reflex between sham dogs and dogs with pacing-induced heart failure. We found 1) that the cardiac sympathetic afferent reflex is augmented in heart failure, 2) tonic cardiac sympathetic afferent inputs play an important role in the elevated sympathetic tone in heart failure, 3) cardiac sympathetic afferents are sensitized in heart failure and 4) the central gain of the cardiac sympathetic afferent reflex in heart failure is sensitized and that this sensitization may be related to augmented central Ang II and blunted NO mechanisms. These studies integrate into the regulation of sympathetic outflow in heart failure which is likely to be mediated by a variety of peripheral inputs modulated by central substances. If the cardiac sympathetic afferent reflex is one of the excitatory reflexes which contribute to sympathetic activation in heart failure, a comprehensive understanding of neuro-humoral regulation of this reflex may result in more definitives and rational therapy targeted to the sympathetic nervous system in this disease state.
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Affiliation(s)
- W Wang
- Department of Physiology and Biophysics, University of Nebraska College of Medicine, Omaha, NE 68198-4575, USA.
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14
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Abstract
The cardiac neuronal hierarchy can be represented as a redundant control system made up of spatially distributed cell stations comprising afferent, efferent, and interconnecting neurons. Its peripheral and central neurons are in constant communication with one another such that, for the most part, it behaves as a stochastic control system. Neurons distributed throughout this hierarchy interconnect via specific linkages such that each neuronal cell station is involved in temporally dependent cardio-cardiac reflexes that control overlapping, spatially organized cardiac regions. Its function depends primarily, but not exclusively, on inputs arising from afferent neurons transducing the cardiovascular milieu to directly or indirectly (via interconnecting neurons) modify cardiac motor neurons coordinating regional cardiac behavior. As the function of the whole is greater than that of its individual parts, stable cardiac control occurs most of the time in the absence of direct cause and effect. During altered cardiac status, its redundancy normally represents a stabilizing feature. However, in the presence of regional myocardial ischemia, components within the intrinsic cardiac nervous system undergo pathological change. That, along with any consequent remodeling of the cardiac neuronal hierarchy, alters its spatially and temporally organized reflexes such that populations of neurons, acting in isolation, may destabilize efferent neuronal control of regional cardiac electrical and/or mechanical events.
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Affiliation(s)
- J Andrew Armour
- Department of Pharmacology, Faculty of Medicine, University of Montréal, Montreal, Québec, H3C 3J7 Canada.
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15
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Brugnaro M, De Souza RR, Ribeiro AACM. Extrinsic cardiac nerve segments in the domestic dog (Canis familiaris- Linnaeus, 1758). Comparative study in young and adult dogs. Anat Histol Embryol 2003; 32:228-32. [PMID: 12919074 DOI: 10.1046/j.1439-0264.2003.00468.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
In this paper, important connections between the two main contingents of the autonomic nervous system, intrinsic and extrinsic visceral plexus were analysed. Concerning heart innervation, the territories of extrinsic innervation are very important in the treatment of congenital or acquired cardiopathy, thoracic neoplasia and aortic arch persistence, among others. This research compared young and adult extrinsic cardiac innervation and described the surgical anatomic nerve segments. Animals were perfused with a 10% formaldehyde solution in PBS (0.1 m) (pH 7.4) and submitted to macro- and meso-scopic dissection immersed in 60% acetic acid alcoholic solution and 20% hydrogen peroxide aqueous solution. The nerve segments were assigned as: right vagus nerve segment, left vagus nerve segment, right middle cervical ganglion segment, left middle cervical ganglion segment, right caudal laryngeal nerve segment, left caudal laryngeal nerve segment, right phrenic nerve segment and left phrenic nerve segment.
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Affiliation(s)
- M Brugnaro
- Department of Surgery, College of Veterinary Medicine, São Paulo University (USP), São Paulo, Brazil
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Abstract
BACKGROUND Although connections of stellate ganglion (SG) have been widely explored, some features of pathways and projections remain unknown, such as the source and fate of preganglionic axons present in output branches, including both synaptically interrupted and traversing pathways as well as axon composition (efferent and afferent) of these output nerves. METHODS Circuits and central projections of cat SG were investigated using horseradish peroxidase (HRP) tracer and electrophysiologic techniques including stimulation of ganglionic branches during recording of genesis of compound action potentials in other nerves or centrally evoked responses. RESULTS All branches of SG including vertebral nerve are mixed, i.e., they contain axons that synapse in the periphery or traverse ganglia. A novel synaptically interrupted pathway bi-directionally coursing along subclavian branches and inferior cardiac nerve was identified. Preganglionic axons traversing stellate ganglion course in communicating branch to vagus nerve and to inferior cardiac nerve, a small number of these preganglionic axons traversing stellate ganglion reach cervical sympathetic trunk via subclavian branches. For the first time, a small number of preganglionic traversing pathways were also detected in vertebral nerve. Afferent axons with somata located in C8-T7 dorsal root ganglia, identified in all branches of SG, projected centrally to neurons in thalamus and somatosensory zones of cerebral cortex and coincided with afferent projections of brachial plexus. CONCLUSIONS Present data contribute to the morphologic description of autonomic regulation of thoracic organs, including centrally independent peripheral autonomic axon reflexes.
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Buller KM, Bolter CP. Carotid bifurcation pressure modulation of spontaneous activity in external and internal carotid nerves can occur in the superior cervical ganglion. JOURNAL OF THE AUTONOMIC NERVOUS SYSTEM 1997; 67:24-30. [PMID: 9470141 DOI: 10.1016/s0165-1838(97)00088-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Previous reports have suggested that a peripheral pressure-modulated reflex operates at the level of the superior cervical ganglion to alter evoked activity in the postganglionic nerves of the ganglion in both the cat and rabbit. In the present study we have examined if spontaneous activity of the external and internal carotid nerves of the rabbit superior cervical ganglion can be modulated during changes of the carotid bifurcation pressure (CBP), independent of central nervous system (CNS) integration. For external carotid nerve recordings increases in CBP resulted in a reduction in spontaneous activity while decreases in CBP were associated with an increase in spontaneous activity. For internal carotid nerve recordings similar effects were observed in the majority of recordings although a subset of recordings showed opposite effects or were not responsive to changes in pressure. To determine if vagus nerve afferents contribute to the observed pressure-modulated spontaneous activity effects, the influence of CBP on external carotid nerve recordings was examined before and after section of the vagus nerve rostral to the nodose ganglion. We found that even following section of the vagus nerve the external carotid nerve response to an increase in pressure remained intact. These results demonstrate that, after section of centrally-projecting afferent pathways from the carotid bifurcation to the CNS, changes in CBP can still modify spontaneous sympathetic activity of the rabbit superior cervical ganglion. The data reinforce previous findings related to evoked responses in the postganglionic nerves and also suggest that a pressure-modulated reflex, integrated at the level of the superior cervical ganglion, can influence ongoing sympathetic nervous outflow from the superior cervical ganglion in the rabbit.
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Affiliation(s)
- K M Buller
- Department of Physiology, University of Otago, Dunedin, New Zealand
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Abstract
The properties of the postganglionic sympathetic neurones supplying the heart and arising in the stellate and adjacent paravertebral ganglia of various species are discussed with respect to their location, morphology, synaptic input and membrane characteristics. Results from our laboratory on the morphology of rat stellate neurones projecting to the heart were obtained either by intracellular injection of hexammine cobaltic (III) chloride or by retrograde labelling of cells using cobalt-lysine complex. Intracellular recordings were made from cells using electrodes filled either with potassium chloride plus hexammine cobaltic chloride or potassium acetate. Neurones which projected axons into cardiac nerve branches arising from the stellate ganglion were termed putative cardiac neurones, because of the possibility that some supply pulmonary targets. Putative cardiac neurones had unbranched axons and were ovoid or polygonal in shape, but showed considerable variation in soma size and in the complexity of dendritic trees. The mean two-dimensional surface area was 463 microns2 and the mean number of primary dendrites was seven. Other studies have found that the morphology of rat stellate ganglion neurones is similar to that of superior cervical ganglion cells. However, in strains of rat displaying spontaneous hypertension, dendritic length may be increased. Histochemical studies do not, as yet, seem to have demonstrated a distinctive neurochemical profile for stellate cardiac neurones, but various types of peptide-containing intraganglionic nerve fibres have been identified in the guinea pig. In our electrophysiological studies, putative cardiac neurones were found to receive a complex presynaptic input arising from the caudal sympathetic trunk and from T1 and T2 thoracic rami. In addition, 16% of cardiac neurones received a synaptic input from the cardiac nerve. The properties of postganglionic parasympathetic neurones distributed in the cardiac plexus and termed intrinsic cardiac neurones are discussed, including the results of studies on cultures of these neurones.
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MESH Headings
- Animals
- Axons/physiology
- Cell Membrane/chemistry
- Cell Membrane/physiology
- Dendrites/physiology
- Electric Conductivity
- Ganglia, Autonomic/anatomy & histology
- Ganglia, Autonomic/cytology
- Ganglia, Autonomic/physiology
- Ganglia, Parasympathetic/anatomy & histology
- Ganglia, Parasympathetic/cytology
- Ganglia, Parasympathetic/physiology
- Ganglia, Sympathetic/anatomy & histology
- Ganglia, Sympathetic/cytology
- Ganglia, Sympathetic/physiology
- Heart/innervation
- Immunohistochemistry
- Rats
- Rats, Wistar
- Stellate Ganglion/anatomy & histology
- Stellate Ganglion/cytology
- Stellate Ganglion/physiology
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Affiliation(s)
- D Wallis
- School of Molecular and Medical Biosciences, University of Wales College of Cardiff, Wales
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Buller KM, Bolter CP. Modification of superior cervical ganglion transmission, by changes of carotid bifurcation pressure. JOURNAL OF THE AUTONOMIC NERVOUS SYSTEM 1996; 59:159-64. [PMID: 8832522 DOI: 10.1016/0165-1838(96)00020-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
We investigated the effect of alterations in carotid bifurcation pressure on transmission in the superior cervical ganglion of pentobarbital-anaesthetized rabbits. Compound action potentials were evoked in the internal and external carotid nerves (post-ganglionic fibres) by electrical stimulation of the decentralized cervical sympathetic trunk. Pressure in the ipsilateral isolated carotid bifurcation (CBP) was maintained at a control value of 100 mmHg. Increases of CBP to between 125 and 200 mmHg caused graded reductions in the height and increases in the time to peak (TTP) of the S2 wave of the compound action potential recorded from the external carotid nerve (mean +/- SEM: -5.8 +/- 0.9% and +3.0 +/- 0.5%, respectively, at 200 mmHg, P < 0.05). In the same nerve, reductions in CBP to between 25 and 75 mmHg caused graduated increases in the height and decreases in TTP of the S2 wave (+6.3 +/- 0.8% and -2.8 +/- 0.4% at 25 mmHg, P < 0.05). Similar responses were obtained from the internal carotid nerve. The response of the S2 wave in the external carotid nerve to a step increase of CBP from 100 to 175 mmHg was examined before and after section of either the ganglioglomerular or carotid sinus nerve. Section of the ganglioglomerular nerve abolished the response (height and TTP of the S2 wave: before -10.7 +/- 0.8% and +5.9 +/- 0.9%; after -0.6 +/- 0.6% and +0.2 +/- 0.5%, P < 0.05). Section of the carotid sinus nerve had no effect on the S2 wave response. It appears that a population of ganglioglomerular nerve fibres, with pressure-sensitive endings located in the wall of the carotid bifurcation, form the afferent limb of a reflex integrated in the superior cervical ganglion of the rabbit. The efferent limb includes postganglionic fibres in the internal and external carotid nerves.
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Affiliation(s)
- K M Buller
- Department of Physiology, University of Otago, Dunedin, New Zealand
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Sica AL, Gootman PM, Gootman N, Armour JA. Neuronal activity of the stellate ganglia in neonatal swine. JOURNAL OF THE AUTONOMIC NERVOUS SYSTEM 1994; 48:273-7. [PMID: 7963261 DOI: 10.1016/0165-1838(94)90056-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
In anesthetized, paralyzed, and artificially ventilated neonatal pigs, neuronal activity was recorded extracellularly from the intact right stellate ganglion. Of 301 investigated neurons, only a few had spontaneous activity: 27 neurons generated activity either during lung inflation or deflation, and 1 neuron generated activity related to the cardiac cycle. The remaining 273 neurons were activated by stroking of body hair or by light pressure applied to various somatic sites. These data suggest that much of the spontaneous activity in the stellate ganglia appear later during development.
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Affiliation(s)
- A L Sica
- Pediatric Research Center, Schneider Children's Hospital, Long Island Jewish Medical Center, New Hyde Park, NY 11042
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Kummer W, Oberst P. Neuronal projections to the guinea pig stellate ganglion investigated by retrograde tracing. JOURNAL OF THE AUTONOMIC NERVOUS SYSTEM 1993; 42:71-80. [PMID: 7679687 DOI: 10.1016/0165-1838(93)90343-s] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Previous electrophysiological studies have revealed a peripheral sensory input to the stellate ganglion which does not originate from the dorsal root ganglia. The present retrograde tracing study aimed at evaluating whether the parent cell bodies are located in the periphery, i.e. in mediastinal ganglia. Following injection of Fast blue or wheat germ agglutinin-horseradish peroxidase into the right stellate ganglion of the guinea pig, retrogradely labelled cell bodies were observed in the intermediolateral and intercalated nuclei of the spinal cord as well as in dorsal root ganglia at segmental levels C8 to T6. In another case, the stellate ganglion was resected and replaced by a sponge soaked with 10 microliters of Fast blue. Labelling of preganglionic and sensory neurons parallelled that obtained by tracer injections. In neither case, however, were retrogradely labelled neurons found within or around the thoracic viscera (thymus, trachea, bronchi, esophagus, heart, great vessels of upper mediastinum) when these were cut serially en bloc. Controls performed by injection of Fast blue into the inferior mesenteric ganglion and investigation of the distal colon showed that our experimental protocol was able to visualize a peripheral projection towards a sympathetic ganglion--in this case from myenteric ganglia to the inferior mesenteric ganglion. We conclude that, in contrast to the circuitry connecting prevertebral sympathetic ganglia with the gut, the neuronal cell bodies providing peripheral sensory input from thoracic viscera to the right stellate ganglion most likely are not located within the mediastinal ganglia. Instead, they may reside within the stellate ganglion itself.
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Affiliation(s)
- W Kummer
- Institute for Anatomy and Cell Biology, Ruprecht-Karls-University, Heidelberg, FRG
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Abstract
The autonomic nervous system is divided into the sympathetic, parasympathetic and enteric subdivisions. The present review is focussed upon the highly specialized reflex organization and neurochemistry of sympathetic parasympathetic neurons. The currently available informations allow to conclude that autonomic control of each peripheral target tissue is specifically regulated under normal conditions but nevertheless able to respond to altered conditions by changes in neural activity and mediator expression.
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Affiliation(s)
- W Kummer
- Institute for Anatomy and Cell Biology, Ruprecht-Karls-University, Heidelberg, Germany
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Abstract
In order to study the effects of peptides on intrinsic cardiac neurons, substance P, bradykinin, oxytocin, calcitonin gene related peptide, atrial natriuretic peptide and vasoactive intestinal peptide were administered into canine atrial or ventricular ganglionated plexi. When substance P was injected into right atrial or cranial medial ventricular ganglionated plexi heart rate, atrial force and ventricular intramyocardial pressures were augmented. No cardiac changes occurred when similar volumes of saline (i.e., peptide vehicle) were injected into these ganglionated plexi. When bradykinin was injected into atrial or ventricular ganglionated plexi heart rate, atrial force and ventricular force were augmented in approximately 50% and depressor responses were elicited in approximately 50% of these animals. When oxytocin was injected into right atrial ventral ganglionated plexi heart rate and atrial forces were reduced in five of ten dogs studied. No cardiac changes occurred when oxytocin was injected into left atrial or ventricular ganglionated plexi. No responses were elicited when calcitonin gene related peptide, atrial natriuretic peptide or vasoactive intestinal peptide was administered into atrial or ventricular ganglionated plexi. Following acute decentralization of the heart, no significant responses were elicited by repeat administrations of substance P, bradykinin or oxytocin, implying that connectivity with central nervous system neurons was necessary for consistent responses to be elicited. It is concluded that substance P, bradykinin and oxytocin can affect neurons on the heart such that cardiodynamics are modified, these different peptides eliciting different cardiac responses.
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Affiliation(s)
- J A Armour
- Department of Physiology, Faculty of Medicine, Dalhousie University, Halifax, N.S., Canada
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