By Vasken Dilsizian, Jagat Narula
This atlas elucidates the function of the neuronal part in common cardiovascular functionality and cardiac issues and discusses the presently on hand imaging pursuits and probes. It offers a origin in cardiac neuronal imaging and snapshot processing and serves as a consultant within the potent usage of those options in medical and examine settings. The atlas discusses the foundations of autonomic keep watch over within the legislation of cardiac functionality and affliction; chemistry and biology of radiotracers designed to focus on alterations within the myocardial sympathetic and parasympathetic innervation as a functionality of sickness or therapy; neuronal imaging in middle failure and opposite home improvement and using puppy imaging in quantification of cardiac innervation; cardiac sympathetic innervation in ventricular arrhythmias and machine treatment; stipulations that impact the autonomic apprehensive procedure; and the function of myocardial blood move and cardiac neuronal imaging in denervation and reinnervation in cardiac transplant recipients. that includes full-color illustrations, schematic diagrams, and diagnostic algorithms, Atlas of Cardiac Innervation is a beneficial source for cardiologists, radiologists, nuclear drugs physicians, and electrophysiologists.
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Extra resources for Atlas of Cardiac Innervation
81. Thoracic spinal cord stimulation reduces the risk of ischemic ventricular arrhythmias in a postinfarction heart failure canine model. Circulation. 2005;111:3217–20. 82. Preemptive, but not reactive, spinal cord stimulation mitigates transient ischemia-induced myocardial infarction via cardiac adrenergic neurons. Am J Physiol Heart Circ Physiol. 2007;292:H311–7. 83. Liu Y, Yue WS, Liao SY, Zhang Y, Au KW, Shuto C, Hata C, Park E, Chen P, Siu CW, Tse HF. Thoracic spinal cord stimulation improves cardiac contractile function and myocardial oxygen consumption in a porcine model of ischemic heart failure.
Scale bars: 100 μm (a) and 150 μm (b) (Adapted from Hoover et al. ). Neural Control of Cardiac Function in Health and Disease 25 Cardiac ANS in Disease Known pathways Potential pathways To brainstem and higher brain centers Right stellate ganglion Left stellate ganglion Cervico-thoracic spinal cord Intra-cardiac neural network • Stellate ganglion remodeling • Increased neuronal size • Increased synaptic density • Neurochemical reorganization Increased afferent nerve traffic and transport of NGF Release of NGF and other neural signaling molecules locally and into circulation • Increased nerve activity over time Cardiac neural remodeling • Border zone nerve sprouts • Remote nerve sprouts • Increased ventricular arrhythmias Increased efferent sympathetic nerve traffic Myocardial infarction Scar and denervation Cytokines NGF EADs Stellate ganglion remodeling Myocardial infarction + ↑ Sympathetic activation + Cytokines NGF 26 Atlas of Cardiac Innervation ↑ Dispersion of repolarization Heterogenous substrate Normal cell Nerve sprouts DADs Scar VT/VF Figure 2-12.
A neural mechanism of atrial arrhythmias was first described in 1978 and has since been studied extensively . Experimentally, stimulation of mediastinal nerves during the atrial refractory period has been shown to produce ectopic beats originating near the pulmonary veins and superior vena cava, which in turn may initiate atrial arrhythmias [65, 66]. It is now recognized that the cardiac ANS plays a major role in atrial arrhythmogenesis [67, 68]. The intrinsic cardiac nervous system has been proposed as a target in the treatment of atrial arrhythmias, and ganglionated plexus (GP) ablation is currently being used as an adjunctive or stand-alone treatment [69, 70].