Department of Cardiology, Renmin Hospital of Wuhan University, Cardiovascular Research Institute of Wuhan University, Hubei Key Laboratory of Cardiology, Wuhan City, Hubei Province, China.
Department of Neurosurgery, Renmin Hospital of Wuhan University, Wuhan City, Hubei Province, China.
Int J Med Sci. 2021 Jan 1;18(4):891-901. doi: 10.7150/ijms.50976. eCollection 2021.
To investigate the potential mechanism of ventricular arrhythmias (VAs) after acute ischemic stroke and explore the effects of left stellate gangling (LSG) ablation on VAs induced by stroke in canines. Twenty canines were randomly divided into the sham-operated group (n=6), AS group (n=7) and SGA group (n=7). Cerebral ischemic model was established in the AS group and the SGA group by right acute middle cerebral artery occlusion (MCAO). LSG ablation was performed in the SGA group as soon as MCAO. After 3 days, atrial electrophysiology and neural activity were measured in vivo. The levels of norepinephrine (NE) in plasma and ventricle were detected by ELISA. The levels of monocyte chemotactic protein-1 (MCP-1), tumor necrosis factor-α (TNF-α) and NF-κB p65 in ventricle were detected by western blotting. The pro-inflammatory polarization of macrophages in ventricle was detected by immunofluorescence. Higher ventricular tachycardia (VT) inducibility and lower ventricular fibrillation threshold (VFT) were observed in the AS group compared with those in the sham-operated group, associated with higher LSG activity and NE levels, increased number of M1 macrophages and secretion of inflammatory cytokines in ventricle (all P<0.001). Compared with the AS group, the SGA group had lower VT inducibility and higher VFT, combined with lower NE levels, and reduced number of M1 macrophages and secretion of inflammatory cytokines in ventricle (all P<0.001). LSG ablation could reduce VAs vulnerability after acute stroke by preventing the macrophages polarization and activation induced by sympathetic hyperactivity.
探讨急性缺血性脑卒中后室性心律失常（VA）的潜在机制，并探索左侧星状神经节消融（LSG）对犬卒中诱导的 VA 的影响。
将 20 只犬随机分为假手术组（n=6）、AS 组（n=7）和 SGA 组（n=7）。AS 组和 SGA 组通过右侧大脑中动脉闭塞（MCAO）建立脑缺血模型。SGA 组在 MCAO 后立即进行 LSG 消融。3 天后，在体测量心房电生理和神经活动。ELISA 检测血浆和心室去甲肾上腺素（NE）水平。Western blot 检测心室中单核细胞趋化蛋白-1（MCP-1）、肿瘤坏死因子-α（TNF-α）和 NF-κB p65 的水平。免疫荧光检测心室中巨噬细胞的促炎极化。
与假手术组相比，AS 组的心室心动过速（VT）诱导率更高，心室颤动阈值（VFT）更低，与 LSG 活性和 NE 水平升高、心室 M1 巨噬细胞数量增加和炎性细胞因子分泌增加有关（均 P<0.001）。与 AS 组相比，SGA 组的 VT 诱导率较低，VFT 较高，与 NE 水平降低，以及心室 M1 巨噬细胞数量减少和炎性细胞因子分泌减少有关（均 P<0.001）。
LSG 消融可通过防止交感神经活性增高引起的巨噬细胞极化和激活来降低急性脑卒中后 VA 的易感性。
