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新的实验发现:蛛网膜下腔出血后心脏损伤时自主神经节的危险变化;大脑和心脏之间的一种互为因果关系。

New experimental finding of dangerous autonomic ganglia changes in cardiac injury following subarachnoid hemorrhage; a reciprocal culprit-victim relationship between the brain and heart.

机构信息

Department of Neurosurgery, Medical Faculty, of Ataturk University, Erzurum, Turkey.

Department of Neurosurgery, Medical Faculty of Recep Tayyip, Erdogan University, Rize, Turkey.

出版信息

Int J Neurosci. 2024 Jun;134(2):91-102. doi: 10.1080/00207454.2022.2086128. Epub 2022 Jun 15.

Abstract

OBJECTIVE

The vagal, stellate, and cardiac ganglia cells changes following subarachnoid hemorrhage (SAH) may occur. This study aimed to investigate if there is any relation between vagal network/stellate ganglion and intrinsic cardiac ganglia insult following SAH.

MATERIALS AND METHODS

Twenty-six rabbits were used in this study. Animals were randomly divided as control (GI,  = 5); SHAM 0.75 cc of saline-injected ( = 5) and study with autologous 1.5 cc blood injection into their cisterna magna(GIII,  = 15). All animals were followed for three weeks and then decapitated. Their motor vagal nucleus, nodose, stellate, and intracardiac ganglion cells were estimated by stereological methods and compared statistically.

RESULTS

Numerical documents of heart-respiratory rates, vagal nerve- ICG, and stellate neuron densities as follows: 276 ± 32/min-22 ± 3/min-10.643 ± 1.129/mm-4 ± 1/mm-12 ± 3/mm and 2 ± 1/cm in the control group; 221 ± 22/min-16 ± 4/min-8.699 ± 976/mm-24 ± 9/mm-103 ± 32/mm and 11 ± 3/cm in the SHAM group; and 191 ± 23/min-17 ± 4/min-9.719 ± 932/mm-124 ± 31/mm-1.542 ± 162/mm and 32 ± 9/cm in the SAH (study) group. The animals with burned neuro-cardiac web had more neurons of stellate ganglia and a less normal neuron density of nodose ganglia ( < 0.005).

CONCLUSION

Sypathico-parasympathetic imbalance induced vagal nerve-ICG disruption following SAH could be named as Burned Neurocardiac Web syndrome in contrast to broken heart because ICG/parasympathetic network degeneration could not be detected in classic broken heart syndrome. It was noted that cardiac ganglion degeneration is more prominent in animals' severe degenerated neuron density of nodose ganglia. We concluded that the cardiac ganglia network knitted with vagal-sympathetic-somatosensitive fibers has an important in heart function following SAH. The neurodegeneration of the cardiac may occur in SAH, and cause sudden death.Graphical abstract[Formula: see text].

摘要

目的

蛛网膜下腔出血(SAH)后可能会发生迷走神经、星状和心脏神经节细胞的改变。本研究旨在探讨 SAH 后迷走神经网络/星状神经节与固有心脏神经节损伤之间是否存在关系。

材料和方法

本研究使用了 26 只兔子。动物随机分为对照组(GI,n=5);SHAM 组(n=5),向其脑池内注射 0.75cc 生理盐水;研究组(n=15),向其脑池内注射 1.5cc 自体血。所有动物均随访 3 周,然后断头。通过体视学方法评估其运动性迷走神经核、结状神经节、星状神经节和心脏内神经节细胞,并进行统计学比较。

结果

心-呼吸率、迷走神经-ICG 和星状神经元密度的数值文件如下:对照组为 276±32/min-22±3/min-10.643±1.129/mm-4±1/mm-12±3/mm 和 2±1/cm;SHAM 组为 221±22/min-16±4/min-8.699±976/mm-24±9/mm-103±32/mm 和 11±3/cm;SAH(研究)组为 191±23/min-17±4/min-9.719±932/mm-124±31/mm-1.542±162/mm 和 32±9/cm。患有烧伤性心脏神经网的动物星状神经节的神经元更多,而结状神经节的正常神经元密度更低(<0.005)。

结论

与经典心碎综合征不同,SAH 后交感-副交感神经失衡引起的迷走神经 ICG 破坏可命名为烧伤性心脏神经网综合征,因为在经典心碎综合征中未检测到 ICG/副交感神经网络退化。值得注意的是,心脏神经节的退化在严重神经元密度降低的结状神经节动物中更为明显。我们得出结论,迷走神经-交感神经-躯体感觉纤维编织的心脏神经节网络在 SAH 后心脏功能中具有重要作用。SAH 可导致心脏神经退行性变,从而导致猝死。

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