A critical review of the afferent pathways and the potential chemical mediators involved in cardiac pain

Meller, Stephen T.; Gebhart, G. F.

doi:10.1016/0306-4522(92)90398-l

Cited by 231 publications

(137 citation statements)

References 161 publications

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“…It was reported that angina pain symptoms in 50-60 % of patients were completely relieved after sympathectomy [33,42]. Our previous studies showed that after the treatment with A-317491 in the MI rats, the upregulated systolic blood pressure and heart rate were decreased [27,28,38,50,51,58,59].…”

Section: Discussionmentioning

confidence: 93%

Sensory–sympathetic coupling in superior cervical ganglia after myocardial ischemic injury facilitates sympathoexcitatory action via P2X7 receptor

Peng

et al. 2013

Purinergic Signalling

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P2X receptors participate in cardiovascular regulation and disease. After myocardial ischemic injury, sensorysympathetic coupling between rat cervical DRG nerves and superior cervical ganglia (SCG) facilitated sympathoexcitatory action via P2X 7 receptor. The results showed that after myocardial ischemic injury, the systolic blood pressure, heart rate, serum cardiac enzymes, IL-6, and TNF-α were increased, while the levels of P2X 7 mRNA and protein in SCG were also upregulated. However, these alterations diminished after treatment of myocardial ischemic (MI) rats with the P2X 7 antagonist oxATP. After siRNA P2X 7 in MI rats, the systolic blood pressure, heart rate, serum cardiac enzymes, the expression levels of the satellite glial cell (SGC) or P2X 7 were significantly lower than those in MI group. The phosphorylation of ERK 1/2 in SCG participated in the molecular mechanism of the sympathoexcitatory action induced by the myocardial ischemic injury. Retrograde tracing test revealed the sprouting of CGRP or SP sensory nerves (the markers of sensory afferent fibers) from DRG to SCG neurons. The upregulated P2X 7 receptor promoted the activation of SGCs in SCG, resulting in the formation of sensory-sympathetic coupling which facilitated the sympathoexcitatory action. P2X 7 antagonist oxATP could inhibit the activation of SGCs and interrupt the formation of sensory-sympathetic coupling in SCG after the myocardial ischemic injury. Our findings may benefit the treatment of coronary heart disease and other cardiovascular diseases.

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Section: Discussionmentioning

confidence: 93%

Sensory–sympathetic coupling in superior cervical ganglia after myocardial ischemic injury facilitates sympathoexcitatory action via P2X7 receptor

Peng

et al. 2013

Purinergic Signalling

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“…38) Comprehensive review of the cardiac afferent innervation can be found elsewhere. 39) Although often misrepresented as insensitive to pain (except in its lower portion), 40) innervation of the pericardium is provided by the vagus, phrenic, anterior intercostal, and sympathetic nerves that pass through the cardiac plexus.…”

Section: Discussionmentioning

confidence: 99%

Behavioral Changes Following Experimentally-Induced Acute Myocardial Infarction in Rats

et al. 2014

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SummaryRats with experimentally-induced acute myocardial infarction (AMI) have proven to be a clinically relevant model for visceral pain. As there are no behavioral data available on rats in the postinfarction period, we aimed to identify specifi c pain-related behavioral changes following AMI to increase the validity of the model. AMI was induced by left coronary artery ligation and pain-related behavior was analyzed using the open fi eld test (OFT) and elevated plus maze (EPM). Morphine was applied following AMI induction to differentiate pain-related changes from those related to nonspecifi c global changes in responsiveness. AMI was histologically confi rmed.Hypolocomotion was consistently evident in all behavioral tests for both the infarcted group and sham group. In the OFT, both AMI and sham rats exhibited less exploratory behavior and less activity. A similar pattern of behavior was observed in EPM, where both surgical groups showed fewer entries to the open arms and spent less time in the open arms. The sham group with an intact pericardium showed the same pattern of activity as control rats. The reduction in activity and rearing observed following AMI was successfully reversed following morphine injection. This effect was abolished after naloxone application allowing us to attribute observed changes specifi cally to pain.This study demonstrates that pain-related behavior in the acute postinfarction period is generally characterized by reduced mobility and explorative behavior. Our results showed that cardiac ischemia as a consequence of experimentally-induced infarction is a less important source of pain behavior than manipulation of the pericardium. (Int Heart J 2014; 55: 169-177) Key words: Pericardium, Postoperative pain, Behavior C hest pain is the primary and the most prominent symptom leading to the hospitalization of patients with the diagnosis of acute myocardial infarction (AMI). 1)These patients account for 20% of patients in medical emergency departments.2) However, chest pain related to AMI varies signifi cantly both in its intensity 3,4) and incidence. 5,6) In addition, the pain severity does not seem to be a good predictor of the outcome of myocardial infarction. 7)While the evaluation of pain in humans is predominantly based on conscious perception, in animals it relies mainly on behavioral output. 8) Defined by the International Association for the Study of Pain (IASP) as an unpleasant sensory and emotional experience, 9) pain cannot be determined in animals, so proxy indicators are typically used. In order to increase the translational value of their studies, pain researchers working with experimental animals have focused more on complex behavioral responses and operant measures.10,11) Visceral pain models, eg, models of cardiac ischemia, delineate well these challenges. Pain elicited in these models is vague, with no specifi c region to focus pain measurements on, so broader behavioral and cognitive analysis is necessary to detect potential changes.12)The most commonly used stimuli i...

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“…63,64 A significant amount of work by Foreman 18 has shown that dorsal column stimulation inhibits the activity of spinothalamic tracts cells evoked by activation of the cardiac sympathetic afferents or by intracardiac bradykinin. On the other hand, the effects of stimulation might be equivalent to those of a sympathectomy and may act by producing a prolonged inhibition of the hyperactive sympathetic system.…”

Section: Anginamentioning

confidence: 99%

Spinal Cord Stimulation: An Update

2008

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Summary:Spinal cord stimulation has been used in the treatment of many chronic pain disorders since 1967. In this update, the indications for spinal cord stimulation are reviewed with attention to recent publications. A focused review of the literature on abdominal and visceral pain syndromes is also provided. Furthermore, the technology has evolved from the use of monopolar electrodes to complex electrode arrays. Similarly, the power source has changed from a radio frequency-driven system to a rechargeable impulse generator. These topics are covered, along with a short discussion of implant technique. Finally, we include a review of complications of such therapy. SCS as a technology and therapy continues to evolve.

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A critical review of the afferent pathways and the potential chemical mediators involved in cardiac pain

Cited by 231 publications

References 161 publications

Sensory–sympathetic coupling in superior cervical ganglia after myocardial ischemic injury facilitates sympathoexcitatory action via P2X7 receptor

Sensory–sympathetic coupling in superior cervical ganglia after myocardial ischemic injury facilitates sympathoexcitatory action via P2X7 receptor

Behavioral Changes Following Experimentally-Induced Acute Myocardial Infarction in Rats

Spinal Cord Stimulation: An Update

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