Changes in cardiocirculatory autonomic function after thoracoscopic upper dorsal sympathicolysis for essential hyperhidrosis

Noppen, Marc; Dendale, Paul; Hagers, Yves; Herregodts, Patrick; Vincken, Walter; D’Haens, Jean

doi:10.1016/0165-1838(96)00034-3

Cited by 61 publications

(47 citation statements)

References 14 publications

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“…This means that the post-surgical restoration of autonomic modulation may reflect the significant imbalance in autonomic cardiac function in patients diagnosed with hyperhidrosis, and that ETS resulted in changes in HRV indices that are normal relative to individuals without autonomic disorders. These findings partially contrast with previous studies that have assessed resting HRV indices in hyperhidrosis patients (without surgical intervention) relative to matched controls [4,13,14]. In a large study of 63 hyperhidrosis patients and 28 healthy controls, Birner et al did not find differences in HRV indices while supine, however, upon standing, the patients evidenced less HF power compared to controls suggesting parasympathetic dysfunction [13].…”

Section: Discussioncontrasting

confidence: 65%

“…Preoperatively, in addition to abnormal sudomotor control (excessive sweating), sympathetic cardiovascular regulation may also be affected in severe cases of hyperhidrosis. Blunted reflex bradycardia to parasympathomimetic maneuvers such as a Valsalva maneuver or cold water face immersion, and an increased heart rate response to orthostatic stress suggest a hyperfunctioning sympathetic discharge [3,4] in these patients. In addition to sympathetic cardiovascular regulation abnormalities, conflicting data exist regarding the effect of sympathectomy procedures on the QT interval.…”

Section: Introductionmentioning

confidence: 97%

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Autonomic function following endoscopic thoracic sympathotomy for hyperhidrosis

et al. 2010

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We conclude that ETS changes cardiac autonomic modulation of HR to levels similar to controls. Despite the minimally destructive nature of ETS, effects on HRV are consistent with previously reported post-sympathectomy blunting of exaggerated sympathetic control associated with hyperhidrosis. No significant changes in the baroreflex indices suggest that ETS did not significantly affect blood pressure regulation.

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Section: Discussioncontrasting

confidence: 65%

Section: Introductionmentioning

confidence: 97%

Autonomic function following endoscopic thoracic sympathotomy for hyperhidrosis

et al. 2010

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“…In addition, the increase in MAP in response to right handgrip was significantly reduced after right TST, whereas the pressor response to left handgrip did not change (Figure 1). Because TST causes partial cardiac adrenergic denervation, 6 heart rate at rest and during exercise was significantly lower after the operation (Figure 1). However, no difference existed between the chronotropic response to right or left handgrip before and after right TST (Figure 1).…”

Section: Exercise Performancementioning

confidence: 99%

“…Idiopathic hyperhidrosis of the hands or axillae has been attributed to overactivity of the sympathetic fibers that pass through the upper thoracic sympathetic ganglia. 6 Transection of the sympathetic trunk between the first and second thoracic sympathetic ganglia, with diathermy coagulation of the lower end of the divided trunk, produces long-lasting ipsilateral sympathetic denervation of the upper limb, resulting in inhibition of eccrine sweat gland activity and an increase in forearm blood flow in 95% of patients. 5 We studied the effect of TST on forearm exercise performance, blood flow, and muscle bioenergetics (which were evaluated by 31 phosphorus magnetic resonance spectroscopy [ 31 P MRS]).…”

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confidence: 99%

Sympathetic Denervation of the Upper Limb Improves Forearm Exercise Performance and Skeletal Muscle Bioenergetics

et al. 2000

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Background-Sympathetic activation may limit exercise performance by restraining muscle blood flow or by negatively affecting skeletal muscle metabolic behavior. To test this hypothesis, we studied the effect of thoracoscopic sympathetic trunkotomy (TST) on forearm exercise duration, blood flow, and muscle bioenergetics in 13 patients with idiopathic palmar hyperhidrosis. Methods and Results-Heart rate and beat-by-beat mean arterial pressure were recorded at rest and during right and left rhythmic handgrip before and 4 to 7 weeks after right TST. Forearm blood flow was measured bilaterally at rest and on the right during exercise. Right forearm muscle phosphocreatine content and intracellular pH were assessed by 31 phosphorus magnetic resonance spectroscopy. After right TST, exercise duration increased from 8.9Ϯ1.4 to 13.4Ϯ1.8 minutes (PϽ0.0001) with the right forearm and from 5.7Ϯ0.4 to 7.6Ϯ0.9 minutes (PϽ0.05) with the left (PϽ0.05 for the interaction between treatment and side). Right forearm blood flow at rest was 66% higher (PϽ0.01) after right TST, but this difference decreased as the exercise progressed. After right TST, a significant reduction occurred in muscle acidification and phosphocreatine depletion during ipsilateral forearm exercise. This was associated with a significantly reduced mean arterial pressure response to right handgrip, whereas the pressor response to left handgrip did not change. Conclusions-Sympathetic denervation of the upper limb significantly improves forearm skeletal muscle bioenergetics and exercise performance in patients with idiopathic palmar hyperhidrosis.

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“…The pathophysiology of this condition is unknown but it has been attributed to overactivity of the sympathetic fibers that pass through the upper thorasic sympathetic ganglia (Noppen et al 1996). Sympathetic fibers to eccrine glands of palms of the hand arise from stellate and upper thoracic ganglia which also innervate lung, heart, and blood vessels of the upper limb (Firestone 1989;Kingma et al 2002).…”

mentioning

confidence: 99%

Impaired Left Ventricular Filling in Patients with Essential Hyperhidrosis: An Echo-Doppler Study

Sağlam

Esen

Barutçu

et al. 2006

Tohoku J. Exp. Med.

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Essential hyperhidrosis is a well recognized dermatologic and neurologic disorder, characterized by excessive sweating of the eccrine sweat glands. It is also associated with cardiac autonomic dysfunction because sympathetic fibers to eccrine glands of palms of the hand arise from stellate and upper thoracic ganglia, which also innervate the heart. In this study, we investigated cardiac function in patients with essential hyperhidrosis by conventional and tissue Doppler imaging methods. Eighteen subjects with essential hyperhidrosis and eighteen control subjects were included in this study. Pulsed-wave Doppler parameters of the left and right ventricles, which represent diastolic filling abnormalities, were obtained by conventional Doppler and tissue Doppler imaging. Isovolumetric relaxation time, isovolumetric contraction time, ejection time and myocardial performance index were also calculated. Mitral inflow peak early (E M ) and late (A M ) velocities and E M /A M ratio, which represent diastolic filling of left ventricle, were significantly lower in hyperhidrotic subjects than in controls. Also, mitral lateral annulus early and late velocities and early/late velocity ratio, reflecting diastolic filling of left ventricle, were significantly lower in hyperhidrotic subjects than those of controls. However, there were no differences between hyperhidrotic subjects and control subjects with regard to the other echocardiographic indices of left and right ventricle diastolic functions. In conclusion, decreased mitral inflow suggests left ventricle diastolic dysfunction in patients with essential hyperhidrosis. This indicates that hyperactivity of sympathetic nervous system in patient with hyperhidrosis may alter cardiac function in long term. essential hyperhidrosis; cardiac function; echocardiography

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Changes in cardiocirculatory autonomic function after thoracoscopic upper dorsal sympathicolysis for essential hyperhidrosis

Cited by 61 publications

References 14 publications

Autonomic function following endoscopic thoracic sympathotomy for hyperhidrosis

Autonomic function following endoscopic thoracic sympathotomy for hyperhidrosis

Sympathetic Denervation of the Upper Limb Improves Forearm Exercise Performance and Skeletal Muscle Bioenergetics

Impaired Left Ventricular Filling in Patients with Essential Hyperhidrosis: An Echo-Doppler Study

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