Cardiac Autonomic Changes After Thoracic Sympathectomy: A Prospective, Randomized Study

Fiorelli, Alfonso; Messina, Giovanni; Chiodini, Paolo; Costanzo, Saveria; Viggiano, Andrea; Monda, Marcellino; Vicidomini, Giovanni; Santini, Mario

doi:10.1016/j.athoracsur.2016.10.055

Cited by 11 publications

(10 citation statements)

References 23 publications

(53 reference statements)

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“…Moreover, the effects of orexin A on body temperature are predominant with respect to food intake. [29] Therefore, orexin A can induce not only an increase but also a decrease in food intake, as in this experiment, however, it always induces an activation of thermogenesis. We can suppose that this peptide elevates the thermal set point, triggering the reactions that help body temperature to reach a new level.…”

Section: Second Experimentsmentioning

confidence: 50%

Orexin system increases energy expenditure by brown adipose tissue activity

Messina¹,

Monda²,

Villano³

et al. 2017

Natl J Physiol Pharm Pharmacol

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Adipose tissue is a biological caloric reservoir that expands itself in response to overnutrition and releases lipids in response to energy deficit. It comprises white adipose tissue, the main energy storage, and brown adipose tissue (BAT), a key site of thermogenesis that dissipates chemical energy as heat. BAT is richly innervated by sympathetic nerve efferent fibers, and its development and activation are mediated by the sympathetic nervous system (SNS). Furthermore, substantial evidences show that BAT activation leads to increased thermogenesis. Thus, the regulation of the SNS tone provides a complex mechanism able to specifically coordinate the function of the organs involved in energy homeostasis. On the other hand, adipose tissue acts as an endocrine organ by producing various signaling cytokines and interacting with some neuropeptides as orexins. Orexins are produced by the lateral hypothalamus and evidences have suggested that orexins promote energy expenditure (EE) through modulation of locomotor activity and BAT thermogenesis. Recent data also suggest that orexins are required for BAT development, differentiation, and function. In the light of this, the orexin neuropeptides are part of a network able to increase EE through modulation of BAT thermogenesis which can be a target to new strategies to reduce the incidences of overweight and obesity. Aim of this review is to report our evidences showing that the autonomic nervous system influences food intake and energy consumption under various conditions, such as injection of orexins, which change the sympathetic and/or parasympathetic activities.

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Section: Second Experimentsmentioning

confidence: 50%

Orexin system increases energy expenditure by brown adipose tissue activity

Messina¹,

Monda²,

Villano³

et al. 2017

Natl J Physiol Pharm Pharmacol

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“…Bradycardia following ETS is fairly common, with one study demonstrating a decreased mean heart rate of 15% at 24 hours, persisting for six months. 4 Overall effect on heart rate is greater in bilateral ETS than unilateral ETS. However, there does not appear to be a consistent lateralising dominance of substellate fibres.…”

mentioning

confidence: 93%

“…Thus, a relative bradycardia post ETS may simply represent normalisation of the heart rate consistent with those without autonomic disorders. 4 Regardless, there has been one reported case of persistent symptomatic bradycardia secondary to unopposed vagotonia post-bilateral ETS, requiring pacemaker insertion. 7 There are also two reported cases of postoperative asystole: one during a second-stage (left then right) sympathectomy, 8 and one requiring pacemaker insertion following bilateral ETS.…”

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confidence: 99%

Asystole following bilateral endoscopic thoracic sympathectomy

Chung¹,

Sieunarine²,

Deague³

et al. 2021

Anaesth Intensive Care

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“…Higher HRV is indicative of a greater capacity of the cardiovascular system to respond to changes in stressful conditions. 14 A reduced HRV is associated with an increased risk for hypertension, CVD, sudden cardiac death (SCD), and cardiac arrhythmias; 8,[15][16][17] indeed, autonomic nervous system imbalance with an increased sympathetic or reduced vagal tone has been implicated in the pathophysiology of SCD. 11,18 HRV analysis provides additional insight into cardiovascular responses to heat exposure.…”

Section: Introductionmentioning

confidence: 99%

Recovery from sauna bathing favorably modulates cardiac autonomic nervous system

Laukkanen

Lipponen

Kunutsor

et al. 2019

Complementary Therapies in Medicine

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Highlights Sauna bathing, an activity that has been a tradition in Finland for thousands of years and mainly used for the purposes of pleasure and relaxation, is becoming increasingly popular in many other populations. Emerging evidence suggests that beyond its use for pleasure, sauna bathing may be linked to several health benefits, which include reduction in the risk of vascular diseases such as high blood pressure, cardiovascular disease, and neurocognitive diseases. It has been postulated that regular sauna bathing may improve cardiovascular function via improved endothelium-dependent dilatation, reduced arterial stiffness, modulation of the autonomic nervous system. This study investigated the effects of sauna bathing on HR and HRV parameters. The study showed that a single sauna exposure leads to significant changes in cardiac autonomic nervous balance as indicated by modulation in the parameters of HRV such as RMSSD, STDRR, LF, HF, and total power.

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Cardiac Autonomic Changes After Thoracic Sympathectomy: A Prospective, Randomized Study

Abstract: Endoscopic thoracic sympathectomy caused a shift of sympathovagal balance toward parasympathetic tone that seems to be associated with the extent of denervation. This trial was registered at clinicaltrials.gov as NCT02733497.

Cited by 11 publications

References 23 publications

Orexin system increases energy expenditure by brown adipose tissue activity

Orexin system increases energy expenditure by brown adipose tissue activity

Asystole following bilateral endoscopic thoracic sympathectomy

Recovery from sauna bathing favorably modulates cardiac autonomic nervous system

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