Changes in cardiocirculatory autonomic function after thoracoscopic upper dorsal sympathicolysis for essential...

Area of Science:

• Cardiology
• Autonomic Neuroscience
• Surgical Innovation

Background:

• Essential hyperhidrosis (EH) is linked to sympathetic nervous system overactivity, specifically involving dorsal sympathetic ganglia D2 and D3.
• The D2 and D3 ganglia also innervate the heart, suggesting potential cardiocirculatory autonomic dysfunction in EH patients.
• Understanding sympathetic nervous system function in EH is crucial for evaluating treatment efficacy.

Purpose of the Study:

• To investigate sympathetic nervous system function in patients with Essential Hyperhidrosis (EH).
• To assess the cardiocirculatory autonomic effects of thoracoscopic sympathicolysis in EH patients.
• To compare autonomic function in EH patients with healthy volunteers and evaluate post-intervention changes.

Main Methods:

• Cardiocirculatory autonomic function tests were performed on 13 EH patients before and 6 weeks after thoracoscopic sympathicolysis.
• Baseline data from EH patients were compared to 13 matched healthy volunteers.
• Tests included resting heart rate, heart rate variability, exercise tests, and handgrip tests.

Main Results:

• EH patients exhibited increased resting heart rate and heart rate variability ratio in the standing position compared to controls.
• Thoracoscopic sympathicolysis significantly decreased resting heart rate (lying and standing) and heart rate during maximal exercise.
• Post-intervention, diastolic blood pressure response to handgrip test was reduced, while exercise capacity remained unchanged.

Conclusions:

• Patients with EH demonstrate sympathetic system overfunction, with heightened responses to stress.
• Thoracoscopic D2-D3 sympathicolysis effectively corrects this sympathetic hyperfunction.
• The procedure exhibits partial beta-blocker-like activity, reducing cardiovascular responses to stress and rest.