Abstract

OBJECTIVES:To evaluate the effects of sympathectomy on the myocardium in an experimental model.METHODS:The study evaluated three groups of male Wistar rats: control (CT; n=15), left unilateral sympathectomy (UNI; n=15), and bilateral sympathectomy (BIL; n=31). Sympathectomy was performed by injection of absolute alcohol into the space of the spinous process of the C7 vertebra. After 6 weeks, we assessed the chronotropic properties at rest and stress, cardiovascular autonomic modulation, myocardial and peripheral catecholamines, and beta-adrenergic receptors in the myocardium. The treadmill test consisted of an escalated protocol with a velocity increment until the maximal velocity tolerated by the animal was reached.RESULTS:The bilateral group had higher levels of peripheral catecholamines, and consequently, a higher heart rate (HR) and blood pressure levels. This suggests that the activation of a compensatory pathway in this group may have deleterious effects. The BIL group had basal tachycardia immediately before the exercise test and increased tachycardia at peak exercise (p<0.01); the blood pressure had the same pattern (p=0.0365). The variables related to autonomic modulation were not significantly different between groups, with the exception of the high frequency (HF) variable, which showed significant differences in CT vs UNI. There was no significant difference in beta receptor expression between groups. There was a higher concentration of peripheral norepinephrine in the BIL group (p=0.0001), and no significant difference in myocardial norepinephrine (p=0.09).CONCLUSION:These findings suggest that an extra cardiac compensatory pathway increases the sympathetic tonus and maintains a higher HR and higher levels of peripheral catecholamines in the procedure groups. The increase in HF activity can be interpreted as an attempt to increase the parasympathetic tonus to balance the greater sympathetic activity.

Highlights

  • Heart failure (HF) is estimated to affect 1% to 2% of the population, reaching 10% in those over 70 years of age, and it’s prevalence is growing rapidly in developed countries [1]

  • A total of 15 animals were included in the CT and unilateral sympathectomy (UNI) groups, and 31 animals were included in the bilateral sympathectomy (BIL) group

  • Electrocardiogram At resting ECG, there were no significant differences in heart rate (HR), QTc, and PR interval between the groups

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Summary

Introduction

Heart failure (HF) is estimated to affect 1% to 2% of the population, reaching 10% in those over 70 years of age, and it’s prevalence is growing rapidly in developed countries [1]. Despite the fact that spending for HF treatment is high, mortality remains high. The publication of the benefits of beta-blockers in heart failure has led to a relative risk reduction in mortality of approximately 30% [2]. Other possibilities for interventional or device-based approaches through the modulation of autonomic activity, such as spinal cord stimulation, vagus nerve stimulation, baroreflex activation. Received for publication on April 28, 2020. Accepted for publication on September 8, 2020

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