Skin sympathetic nerve activity and ST-segment depression in women
Sanjana S Borle1,2, Xiao Liu2, Anxhela Kote2
1Barbra Streisand Women's Heart Center, Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California.
Heart Rhythm O2
|July 10, 2024
Summary
Asymptomatic ST depression in women is linked to increased skin sympathetic nerve activity (SKNA). Heightened SKNA also occurs during ischemic ST depression, suggesting ST depression is a physiological response to sympathetic tone, potentially worsened by myocardial ischemia.
Area of Science:
- Cardiology
- Autonomic Nervous System Research
- Electrophysiology
Background:
- ST-segment depression on electrocardiograms (ECG) can occur without myocardial ischemia, with unclear underlying mechanisms.
- Understanding non-ischemic ST depression is crucial for accurate cardiac diagnosis.
Purpose of the Study:
- To investigate the relationship between skin sympathetic nerve activity (SKNA) and ST-segment height during ambulatory monitoring.
- To test the hypothesis that higher SKNA correlates with lower ST-segment height.
Main Methods:
- Simultaneous recording of SKNA and ECG using neuECG in healthy women, women with Takotsubo syndrome (TTS), and women with ischemia with no obstructive coronary arteries (INOCA).
- Measurement of ambulatory ST height and average SKNA (aSKNA).
Main Results:
- A significant negative correlation between ST height and aSKNA was observed in all participants.
- Asymptomatic ST depression in healthy women was associated with elevated SKNA.
- Ischemic ST depression episodes in TTS and INOCA participants showed significantly higher SKNA burst area compared to non-ischemic episodes.
Conclusions:
- Ambulatory ST depression in women is associated with elevated SKNA, indicating a physiological response to sympathetic tone.
- Myocardial ischemia can exacerbate ST depression in the presence of heightened sympathetic activity.
Keywords:
Ambulatory monitoringExercise testingJ-wave syndromeMyocardial ischemiaSympathetic nerve activityTakotsubo syndromeneuECGMore Related Videos
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