Complete denervation of the heart (autotransplantation) for treatment of severe, refractory coronary spasm

Bertrand, Michel E.; Lablanche, Jean M.; Tilmant, Pierre Y.; Ducloux, G; Warembourg, H; Soots, G

doi:10.1016/0002-9149(81)90271-x

Cited by 54 publications

(14 citation statements)

References 11 publications

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“…Available vasodilators administered systemically are not always sufficient for the complete control of severe variant angina 57,58 and appear to have a smaller dilator effect on pre-arteriolar vessels than on proximal coronary arteries. Complete cardiac denervation, 59 serotonin 60,61 and thromboxane A2 62 blockade did not abolish episodes of coronary spasm. Therefore, the time has come to try and identify novel specific therapeutic targets against the strong coronary constrictor stimuli and against key molecular components of the enhanced constrictor responsiveness that typically characterizes these large and small vasomotor disorders.…”

Section: Innovative Research Strategiesmentioning

confidence: 82%

Role of Coronary Vasoconstriction in Ischemic Heart Disease and Search for Novel Therapeutic Targets

Maseri

Beltrame

Shimokawa

2009

Circ J

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Section: Innovative Research Strategiesmentioning

confidence: 82%

Role of Coronary Vasoconstriction in Ischemic Heart Disease and Search for Novel Therapeutic Targets

Maseri

Beltrame

Shimokawa

2009

Circ J

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“…In models of denervation published in the literature, such as plexectomy [19], transplantation [20], the Randall/ vagotomy technique [21] and autotransplantation [22] only extrinsic innervation was involved both in animals and human beings. These models do not lead to an alteration in the cardiac physiology or morphology.…”

Section: Resultsmentioning

confidence: 99%

Um modelo experimental de ablação do Sistema Nervoso Intrínseco Cardíaco reduz a contratilidade do coração de ratos

Filho¹,

Nakamura²,

Faria³

et al. 2004

Rev Bras Cir Cardiovasc

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Introduction: The function of the Intrinsic Cardiac Nervous System is largely unknown, as is its role in heart disease. In the digestive system, a topic application of Benzalkonium chloride leads to intrinsic denervation of the viscera. Thus, our aim was to obtain an experimental model of cardiac intrinsic denervation by the application of Benzalkonium chloride on the heart. Method: Thirty male Wistar rats received intrapericardial injections of 0.3% Benzalkonium chloride (BC animals) and thirty similar animals received saline (C animals). After 15 days the animals were divided in three groups, with 10 CBtreated and 10 saline-treated animals in each. Group I was submitted to radiological and morphologic studies. The cardiac shadow area (CSA) and cardiothoracic index were calculated in roentgenograms with a semi-automatic image analysis system (MINI-MOP). The day after the animals were weighed and sacrificed with heart, liver and lung collected for histopathologic analysis. The animals of Group II were submitted to a hemodynamic study. Measurements of blood pressure, heart rate and cardiac output were performed using the Cardiomax II thermodilution system and a Thermistor sensor. With the animals of the Group III, the integrity of the extrinsic parasympathetic cardiac innervation was examined by measuring heart rate response to electrical stimulation of the right vagus. Electrical activity was assessed by ECG.Results: CB animals presented increases in cardiothoracic index, CSA, body and liver weight. In these animals the histopathologic analysis showed passive chronic congestion and reduction of the number of atrial neurons. In the hemodynamic study, total peripheral resistance and heart rate were similar in both groups, but blood pressure and cardiac index were reduced in the CB group. The vagal stimulation and ECG were similar in both groups.Conclusion: Intrinsic Cardiac Nervous System denervation caused dilated cardiopathy in rats with left and right heart failure. The etiology of some dilated cardiopathies in human is largely unknown. This unpublished experimental model should provide future studies with the objective of elucidating the relationship between neuronal injures and heart disease.

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“…There are no set rules and therapy must be tailored to the individual depending on the tolerability and response. Selective alpha adreno-receptor blocker may be useful [1,10,11]. The concurrent use of angiotensinconverting enzyme (ACE) inhibitors, acetyle cysteine, diuretics or hydralazine has been reported to reduce nitrate tolerance.…”

Section: Discussionmentioning

confidence: 99%

Refractory case of coronary artery spasm with interesting findings: A case report

et al. 2011

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This is a case of refractory vasospastic angina with unusual electrocardiographic findings and rare coronary angiographic documentation of diffuse spasm of the left coronary system with a baseline of near normal coronary arteries. A 66-year-old man presented with severe vasospastic angina that eventually progressed to non-ST elevation myocardial infarction (NSTEMI). During the episodes of chest pain, the electrocardiogram revealed ST segment depression rather than elevation. Coronary angiography revealed near normal coronary arteries with initial diffuse spasm of the left coronary system. The patient continues to be symptomatic despite treatment with different forms and doses of nitrates and calcium channel blockers.

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Complete denervation of the heart (autotransplantation) for treatment of severe, refractory coronary spasm

Cited by 54 publications

References 11 publications

Role of Coronary Vasoconstriction in Ischemic Heart Disease and Search for Novel Therapeutic Targets

Role of Coronary Vasoconstriction in Ischemic Heart Disease and Search for Novel Therapeutic Targets

Um modelo experimental de ablação do Sistema Nervoso Intrínseco Cardíaco reduz a contratilidade do coração de ratos

Refractory case of coronary artery spasm with interesting findings: A case report

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