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Related Experiment Videos

Thoracic sympathectomy: effects on hemodynamics and baroreflex control.

René Kingma1, Ben J TenVoorde, Gert Jan Scheffer

  • 1Department of Anaesthesiology, VU University Medical Center, Amsterdam, The Netherlands.

Clinical Autonomic Research : Official Journal of the Clinical Autonomic Research Society
|July 10, 2002
PubMed
Summary

Endoscopic thoracic sympathectomy effectively treats hyperhidrosis but impacts cardiovascular control. This procedure alters heart rate and blood pressure, particularly affecting sympathetic vasomotor regulation.

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Area of Science:

  • Cardiovascular Physiology
  • Thoracic Surgery
  • Autonomic Nervous System

Background:

  • Endoscopic thoracic sympathectomy (ETS) is a recognized treatment for hyperhidrosis and facial blushing.
  • The T2-T4 sympathetic ganglia targeted in ETS are crucial for cardiac and vasomotor control.
  • Potential cardiovascular effects of ETS require thorough investigation.

Purpose of the Study:

  • To evaluate changes in steady-state hemodynamics after ETS.
  • To assess beat-to-beat cardiovascular control modifications post-ETS.
  • To determine the impact of ETS on sympathetic and parasympathetic markers.

Main Methods:

  • Non-invasive continuous monitoring of heart rate (HR) and blood pressure (BP) in 12 patients.
  • Hemodynamic parameters (Stroke Volume - SV, Total Peripheral Resistance - TPR) estimated using the Modelflow method.

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  • Analysis of BP and HR power spectra to assess cardiovascular control.

    • Main Results:

    • Reduced mean HR in the sitting position post-ETS.
    • Lowered TPR and BP (diastolic and mean) in both supine and sitting positions.
    • Increased SV and significantly decreased low-frequency power in HR and BP, indicating diminished sympathetic vasomotor control.
    • No significant changes in high-frequency power of HR or baroreflex sensitivity (parasympathetic markers).

    Conclusions:

    • Thoracic sympathectomy at T2-T4 induces measurable alterations in steady-state hemodynamics.
    • The procedure results in modest but significant changes in cardiovascular control, especially concerning peripheral vasomotion.
    • Sympathetic vasomotor control capacity appears reduced following ETS.