Changes in autonomic nervous system activity: spontaneous versus balloon-induced myocardial ischaemia

Abstract

Balloon inflation and occlusion evokes baroreceptor vagal predominance in response to a stretch stimulus of the coronary artery. Conversely, spontaneous occlusion during unstable angina is accompanied by naturally occurring sympathetic activation. Sympathetic activation may have a role in the natural history of the disease.

Functional brown adipose tissue limits cardiomyocyte injury and adverse remodeling in catecholamine-induced cardiomyopathy

“…Sympathetic nervous system activation and norepinephrine release [3], concomitant with the release of natriuretic peptides [4] occur after myocardial injury and during the development of adverse left ventricular (LV) remodeling. Interestingly, these molecules are also major contributors to the growth and stimulation of brown adipose tissue (BAT) [5,6].…”

Multifractal characterization of the autonomous nervous system during prolonged coronary artery occlusion

“…It could be associated to sympathovagal balance of the ANS towards either a sympathetic or parasympathetic prevalence, and may represent a beneficial adaptive mechanism for increasing coronary flow during myocardial ischemia. There are evidence that balloon inflation and occlusion evokes baroreceptor vagal predominance in response to stretch stimulus of the coronary artery [16].…”

Sympathetic neural responses to coronary occlusion during balloon angioplasty

“…Several previous studies with a human angioplasty model focused on an analysis of heart rate variability [15][16][17].…”

“…Manfrini et al [17] have shown that balloon inflation decreases low frequency fluctuation of RR variability, and suggested that coronary occlusion results in sympathetic withdrawal. Studies based on heart rate variability assume that this method measures sympathetic and vagal tone and its balance.…”

“…Experimental coronary occlusion elicits sympathoexcitation, which might exaggerate myocardial ischaemia further by increasing myocardial oxygen consumption [10,11]. Autonomic function during acute myocardial ischaemia in humans has been assessed by indirect measures such as catecholamines [12][13][14], heart rate variability [15][16][17] and baroreflex sensitivity [18,19]. Newton et al [14] have shown, using the norepinephrine spillover technique, that a brief period of myocardial ischaemia caused by angioplasty of the left anterior descending coronary artery decreases cardiac sympathetic activity, despite evidence of generalized sympathoadrenal activation.…”