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[The effects cervicothoracic sympathetic blockade on left ventricular function].

W Schlack1

  • 1Institut für Klinische Anaesthesiologie, Heinrich-Heine Universität Düsseldorf. wolfgang@herzkreis.uni-duesseldorf.de

Anasthesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie : AINS
|September 24, 1999
PubMed
Summary

Stellate ganglion blocks can impair diastolic function and cause asynchronous heart wall motion due to regional sympathetic denervation. However, healthy ventricles can compensate, maintaining cardiac output.

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Area of Science:

  • Cardiology
  • Autonomic Nervous System
  • Cardiac Electrophysiology

Background:

  • Cervicothoracic sympathetic blocks, or stellate ganglion blocks, affect regional sympathetic innervation of the left ventricle.
  • Imbalances in sympathetic innervation can impact ventricular function.

Purpose of the Study:

  • To investigate the influence of sympathetic innervation imbalances on left ventricular function.
  • To assess the effects of stellate ganglion blocks on regional and global ventricular performance.

Main Methods:

  • Animal model: Anesthetized dogs instrumented for left ventricular pressure, cardiac output, and regional myocardial function measurements.
  • Interventions: Electrical stimulation and blockade of stellate ganglia in dogs.
  • Human study: Echocardiographic assessment of ventricular function in patients following left stellate ganglion blocks.

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Main Results:

  • In dogs, stellate ganglion stimulation increased contractility but caused asynchronous wall motion and impaired relaxation.
  • Stellate ganglion blocks in dogs led to decreased regional contractility, asynchronous wall motion, and impaired relaxation, yet cardiac output was maintained.
  • In patients, left stellate ganglion blocks increased isovolumic relaxation time and cardiac output, with afterload reduction.

Conclusions:

  • Stellate ganglion blocks disrupt diastolic function due to asynchronous wall motion post-regional denervation.
  • Ventricular compensatory mechanisms in healthy individuals can manage these changes.
  • Cardiac output is not compromised following stellate ganglion blocks in healthy ventricles.