Relationship between regional cardiac hyperinnervation and ventricular arrhythmia

Ji Min Cao, Michael C. Fishbein, Jay B. Han, William W. Lai, Angela C. Lai, Tsu Juey Wu, Lawrence Czer, Paul L. Wolf, Timothy A. Denton, I. Peter Shintaku, Peng Sheng Chen, Lan S. Chen

Research output: Contribution to journalArticle

320 Citations (Scopus)

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/mm2, total nerve length 3.3± 3.0 mm/mm2) than in group 1B patients (total nerve number 13.5±6.1/mm2, total nerve length 2.0±1.1 mm/mm2, 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.

Original languageEnglish (US)
Pages (from-to)1960-1969
Number of pages10
JournalCirculation
Volume101
Issue number16
DOIs
StatePublished - Apr 25 2000

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Cardiac Arrhythmias
Ventricular Tachycardia
Neurofilament Proteins
S100 Proteins
Sudden Cardiac Death
Tyrosine 3-Monooxygenase
Nerve Fibers
Stroke Volume
Blood Vessels
Autopsy
Myocardium
History
Staining and Labeling
Proteins

Keywords

  • Cardiomyopathy
  • Death, sudden
  • Nervous system
  • Tachycardia

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

Cao, J. M., Fishbein, M. C., Han, J. B., Lai, W. W., Lai, A. C., Wu, T. J., ... Chen, L. S. (2000). Relationship between regional cardiac hyperinnervation and ventricular arrhythmia. Circulation, 101(16), 1960-1969. https://doi.org/10.1161/01.CIR.101.16.1960

Relationship between regional cardiac hyperinnervation and ventricular arrhythmia. / Cao, Ji Min; Fishbein, Michael C.; Han, Jay B.; Lai, William W.; Lai, Angela C.; Wu, Tsu Juey; Czer, Lawrence; Wolf, Paul L.; Denton, Timothy A.; Shintaku, I. Peter; Chen, Peng Sheng; Chen, Lan S.

In: Circulation, Vol. 101, No. 16, 25.04.2000, p. 1960-1969.

Research output: Contribution to journalArticle

Cao, JM, Fishbein, MC, Han, JB, Lai, WW, Lai, AC, Wu, TJ, Czer, L, Wolf, PL, Denton, TA, Shintaku, IP, Chen, PS & Chen, LS 2000, 'Relationship between regional cardiac hyperinnervation and ventricular arrhythmia', Circulation, vol. 101, no. 16, pp. 1960-1969. https://doi.org/10.1161/01.CIR.101.16.1960
Cao JM, Fishbein MC, Han JB, Lai WW, Lai AC, Wu TJ et al. Relationship between regional cardiac hyperinnervation and ventricular arrhythmia. Circulation. 2000 Apr 25;101(16):1960-1969. https://doi.org/10.1161/01.CIR.101.16.1960
Cao, Ji Min ; Fishbein, Michael C. ; Han, Jay B. ; Lai, William W. ; Lai, Angela C. ; Wu, Tsu Juey ; Czer, Lawrence ; Wolf, Paul L. ; Denton, Timothy A. ; Shintaku, I. Peter ; Chen, Peng Sheng ; Chen, Lan S. / Relationship between regional cardiac hyperinnervation and ventricular arrhythmia. In: Circulation. 2000 ; Vol. 101, No. 16. pp. 1960-1969.
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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/mm2, total nerve length 3.3± 3.0 mm/mm2) than in group 1B patients (total nerve number 13.5±6.1/mm2, total nerve length 2.0±1.1 mm/mm2, 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.",
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AU - Cao, Ji Min

AU - Fishbein, Michael C.

AU - Han, Jay B.

AU - Lai, William W.

AU - Lai, Angela C.

AU - Wu, Tsu Juey

AU - Czer, Lawrence

AU - Wolf, Paul L.

AU - Denton, Timothy A.

AU - Shintaku, I. Peter

AU - Chen, Peng Sheng

AU - Chen, Lan S.

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N2 - 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/mm2, total nerve length 3.3± 3.0 mm/mm2) than in group 1B patients (total nerve number 13.5±6.1/mm2, total nerve length 2.0±1.1 mm/mm2, 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.

AB - 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/mm2, total nerve length 3.3± 3.0 mm/mm2) than in group 1B patients (total nerve number 13.5±6.1/mm2, total nerve length 2.0±1.1 mm/mm2, 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.

KW - Cardiomyopathy

KW - Death, sudden

KW - Nervous system

KW - Tachycardia

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