Sympathetic Nerve Activity After Thoracoscopic Cardiac Resynchronization Therapy in Congestive Heart Failure

• Published in: Journal of cardiac failure 2005-09, Vol.11 (7), p.529-533
• Main Authors: Najem, BoutaÏna, Preumont, Nicolas, Unger, Philippe, Jansens, Jean-Luc, Houssière, Anne, Ciarka, Agnieszka, Stoupel, Eric, Degaute, Jean-Paul, van de Borne, Philippe
• Format: Article
• Language: English
• Subjects: Aged; Autonomic nervous system; Blood Pressure - physiology; Echocardiography; Electrocardiography; Exercise Tolerance - physiology; Female; Heart Conduction System - diagnostic imaging; Heart Conduction System - physiopathology; heart failure; Heart Failure - diagnostic imaging; Heart Failure - physiopathology; Heart Failure - therapy; Heart Rate - physiology; Heart Ventricles - diagnostic imaging; Heart Ventricles - physiopathology; Humans; Male; microneurography; Middle Aged; Pacemaker, Artificial; robotics; Stroke Volume - physiology; Sympathetic Nervous System - diagnostic imaging; Sympathetic Nervous System - physiopathology; Thoracoscopy; Treatment Outcome; Walking - physiology
• ISSN: 1071-9164; 1532-8414
• DOI: 10.1016/j.cardfail.2005.04.001

Sympathetic benefits of thoracoscopic cardiac resynchronization therapy (TCRT) in congestive heart failure (CHF) are unknown. We determined cardiac hemodynamics, functional status, and muscle sympathetic nerve activity (MSNA) in a group of TCRT patients. We aimed to compare these patients with CHF patients with cardiac asynchrony (ASY) to substantiate the beneficial effects of TCRT. Eleven patients resynchronized by TCRT 6 ± 1 months before study inclusion (SYN) and 10 matched ASY patients underwent blood pressure, heart rate, and MSNA recordings. All underwent functional status, cardiac index, and left ventricular ejection fraction (LVEF) assessments. SYN patients had shorter QRS duration and interventricular mechanical delays, longer 6 minute walking distance and lower New York Heart Association class (all P < .05) than ASY patients. MSNA of 56 ± 2 bursts/min in ASY patients was higher than in SYN patients (48 ± 3 bursts/min, P < .05). Cardiac index was higher in SYN patients than in ASY patients (2.8 ± 0.2 versus 1.9 ± 0.2 L·min·m 2, P < .05, respectively). MSNA was highest in the patients with the lowest LVEF ( r = −0.49, P < .05), cardiac index ( r = −0.48, P < .05) and 6-minute walking distance ( r = −0.50, P < .05). Lower sympathetic nerve activities in TCRT patients are related to more favorable cardiac indexes and six minute walking distances suggesting a sympathetic, hemodynamic, and functional improvement by TCRT.