Characterization of skin sympathetic nerve activity in patients with cardiomyopathy and ventricular arrhythmia

Pei Zhang, Jin Jun Liang, Cheng Cai, Ying Tian, Ming Yan Dai, Johnson Wong, Thomas H. Everett, Erica D. Wittwer, Gregory W. Barsness, Peng Sheng Chen, Chen Yang Jiang, Yong Mei Cha

Research output: Contribution to journalArticle

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.

Original languageEnglish (US)
Pages (from-to)1669-1675
Number of pages7
JournalHeart Rhythm
Volume16
Issue number11
DOIs
StatePublished - Nov 2019

Fingerprint

Cardiomyopathies
Cardiac Arrhythmias
Skin
General Anesthesia
Electrocardiography

Keywords

  • Autonomic nervous system
  • Sedation
  • Skin sympathetic nerve activity
  • Sympathetic tone
  • Ventricular arrhythmia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Zhang, P., Liang, J. J., Cai, C., Tian, Y., Dai, M. Y., Wong, J., ... Cha, Y. M. (2019). Characterization of skin sympathetic nerve activity in patients with cardiomyopathy and ventricular arrhythmia. Heart Rhythm, 16(11), 1669-1675. https://doi.org/10.1016/j.hrthm.2019.06.008

Characterization of skin sympathetic nerve activity in patients with cardiomyopathy and ventricular arrhythmia. / Zhang, Pei; Liang, Jin Jun; Cai, Cheng; Tian, Ying; Dai, Ming Yan; Wong, Johnson; Everett, Thomas H.; Wittwer, Erica D.; Barsness, Gregory W.; Chen, Peng Sheng; Jiang, Chen Yang; Cha, Yong Mei.

In: Heart Rhythm, Vol. 16, No. 11, 11.2019, p. 1669-1675.

Research output: Contribution to journalArticle

Zhang, P, Liang, JJ, Cai, C, Tian, Y, Dai, MY, Wong, J, Everett, TH, Wittwer, ED, Barsness, GW, Chen, PS, Jiang, CY & Cha, YM 2019, 'Characterization of skin sympathetic nerve activity in patients with cardiomyopathy and ventricular arrhythmia', Heart Rhythm, vol. 16, no. 11, pp. 1669-1675. https://doi.org/10.1016/j.hrthm.2019.06.008
Zhang, Pei ; Liang, Jin Jun ; Cai, Cheng ; Tian, Ying ; Dai, Ming Yan ; Wong, Johnson ; Everett, Thomas H. ; Wittwer, Erica D. ; Barsness, Gregory W. ; Chen, Peng Sheng ; Jiang, Chen Yang ; Cha, Yong Mei. / Characterization of skin sympathetic nerve activity in patients with cardiomyopathy and ventricular arrhythmia. In: Heart Rhythm. 2019 ; Vol. 16, No. 11. pp. 1669-1675.
@article{01977e90cfc441178b05fe6a17f055b9,
title = "Characterization of skin sympathetic nerve activity in patients with cardiomyopathy and ventricular arrhythmia",
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.",
keywords = "Autonomic nervous system, Sedation, Skin sympathetic nerve activity, Sympathetic tone, Ventricular arrhythmia",
author = "Pei Zhang and Liang, {Jin Jun} and Cheng Cai and Ying Tian and Dai, {Ming Yan} and Johnson Wong and Everett, {Thomas H.} and Wittwer, {Erica D.} and Barsness, {Gregory W.} and Chen, {Peng Sheng} and Jiang, {Chen Yang} and Cha, {Yong Mei}",
year = "2019",
month = "11",
doi = "10.1016/j.hrthm.2019.06.008",
language = "English (US)",
volume = "16",
pages = "1669--1675",
journal = "Heart Rhythm",
issn = "1547-5271",
publisher = "Elsevier",
number = "11",

}

TY - JOUR

T1 - Characterization of skin sympathetic nerve activity in patients with cardiomyopathy and ventricular arrhythmia

AU - Zhang, Pei

AU - Liang, Jin Jun

AU - Cai, Cheng

AU - Tian, Ying

AU - Dai, Ming Yan

AU - Wong, Johnson

AU - Everett, Thomas H.

AU - Wittwer, Erica D.

AU - Barsness, Gregory W.

AU - Chen, Peng Sheng

AU - Jiang, Chen Yang

AU - Cha, Yong Mei

PY - 2019/11

Y1 - 2019/11

N2 - 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.

AB - 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.

KW - Autonomic nervous system

KW - Sedation

KW - Skin sympathetic nerve activity

KW - Sympathetic tone

KW - Ventricular arrhythmia

UR - http://www.scopus.com/inward/record.url?scp=85073630410&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85073630410&partnerID=8YFLogxK

U2 - 10.1016/j.hrthm.2019.06.008

DO - 10.1016/j.hrthm.2019.06.008

M3 - Article

C2 - 31201964

AN - SCOPUS:85073630410

VL - 16

SP - 1669

EP - 1675

JO - Heart Rhythm

JF - Heart Rhythm

SN - 1547-5271

IS - 11

ER -