Li Jiakun, Zheng Lihui
National Center for Cardiovascular Diseases, Fuwai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Front Cardiovasc Med. 2022 Jun 23;9:931219. doi: 10.3389/fcvm.2022.931219. eCollection 2022.
This review has summarized the methods currently available for cardiac sympathetic assessment in clinical or under research, with emphasis on the principles behind these methodologies. Heart rate variability (HRV) and other methods based on heart rate pattern analysis can reflect the dominance of sympathetic nerve to sinoatrial node function and indirectly show the average activity level of cardiac sympathetic nerve in a period of time. Sympathetic neurotransmitters play a key role of signal transduction after sympathetic nerve discharges. Plasma or local sympathetic neurotransmitter detection can mediately display sympathetic nerve activity. Given cardiac sympathetic nerve innervation, i.e., the distribution of stellate ganglion and its nerve fibers, stellate ganglion activity can be recorded either directly or subcutaneously, or through the surface of the skin using a neurophysiological approach. Stellate ganglion nerve activity (SGNA), subcutaneous nerve activity (SCNA), and skin sympathetic nerve activity (SKNA) can reflect immediate stellate ganglion discharge activity, i.e., cardiac sympathetic nerve activity. These cardiac sympathetic activity assessment methods are all based on the anatomy and physiology of the heart, especially the sympathetic innervation and the sympathetic regulation of the heart. Technological advances, discipline overlapping, and more understanding of the sympathetic innervation and sympathetic regulation of the heart will promote the development of cardiac sympathetic activity assessment methods.
本综述总结了目前临床或研究中可用的心脏交感神经评估方法，并重点介绍了这些方法背后的原理。心率变异性（HRV）和其他基于心率模式分析的方法可以反映交感神经对窦房结功能的主导作用，并间接显示一段时间内心脏交感神经的平均活动水平。交感神经递质在交感神经放电后起信号转导的关键作用。血浆或局部交感神经递质检测可间接显示交感神经活动。鉴于心脏交感神经的支配，即星状神经节及其神经纤维的分布，可以直接或皮下记录星状神经节的活动，也可以使用神经生理学方法通过皮肤表面进行记录。星状神经节神经活动（SGNA）、皮下神经活动（SCNA）和皮肤交感神经活动（SKNA）可以反映星状神经节的即时放电活动，即心脏交感神经活动。这些心脏交感神经活动评估方法均基于心脏的解剖学和生理学，尤其是交感神经支配和心脏的交感神经调节。技术进步、学科交叉以及对心脏交感神经支配和交感神经调节的更多了解将推动心脏交感神经活动评估方法的发展。
