Li Chang-Yi, Li Yi-Gang
Department of Cardiology, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, 1665 Kongjiang Road, Shanghai 200092, China.
Cardiol Res Pract. 2015;2015:698368. doi: 10.1155/2015/698368. Epub 2015 Dec 17.
Ventricular arrhythmogenesis is thought to be a common cause of sudden cardiac death following myocardial infarction (MI). Nerve remodeling as a result of MI is known to be an important genesis of life-threatening arrhythmias. It is hypothesized that neural modulation might serve as a therapeutic option of malignant arrhythmias. In fact, left stellectomy or β-blocker therapy is shown to be effective in the prevention of ventricular tachyarrhythmias (VT), ventricular fibrillation (VF), and sudden cardiac death (SCD) after MI both in patients and in animal models. Results from decades of research already evidenced a positive relationship between abnormal nerve density and ventricular arrhythmias after MI. In this review, we summarized the molecular mechanisms involved in cardiac sympathetic rejuvenation and mechanisms related to sympathetic hyperinnervation and arrhythmogenesis after MI and analyzed the potential therapeutic implications of nerve sprouting modification for ventricular arrhythmias and SCD control.
室性心律失常被认为是心肌梗死(MI)后心源性猝死的常见原因。已知MI导致的神经重塑是危及生命的心律失常的重要成因。据推测,神经调节可能是治疗恶性心律失常的一种选择。事实上,在患者和动物模型中,左星状神经节切除术或β受体阻滞剂治疗在预防MI后的室性快速心律失常(VT)、心室颤动(VF)和心源性猝死(SCD)方面均显示出有效性。数十年的研究结果已证明MI后神经密度异常与室性心律失常之间存在正相关关系。在本综述中,我们总结了MI后心脏交感神经再生所涉及的分子机制以及与交感神经超支配和心律失常发生相关的机制,并分析了神经芽生修饰对室性心律失常和SCD控制的潜在治疗意义。