Skin sympathetic nerve activity in patients with obstructive sleep apnea

He, Wenbo; Tang, Yuzhu; Meng, Guang; Wang, Danning; Wong, Johnson; Mitscher, Gloria A.; Adams, David; Everett, Thomas H.; Chen, Peng Sheng; Manchanda, Shalini

doi:10.1016/j.hrthm.2020.06.018

Cited by 12 publications

(10 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Since HRV is not real-time and indicates the combined activity of the sympathetic and parasympathetic nerves, the application of SKNA in our study provided a distinct view of the sympathetic trend in these two groups. In a previous study using SKNA recordings, the patients with obstructive sleep apnea (OSA) had higher aSKNA, implying a higher sympathetic tone ( He et al, 2020 ). We did not find a difference between subgroups in baseline aSKNA, which could be related to the small sample size and confounding factors.…”

Section: Discussionmentioning

confidence: 98%

“…Recently, skin sympathetic nerve activity (SKNA) has become a novel noninvasive parameter to reflect real-time cardiac sympathetic nerve activity ( Doytchinova et al, 2017 ; Kusayama et al, 2020 ). This parameter has been widely used in cardiac arrhythmogenesis, acute myocardial infarction, sleep apnea, and neurologic recovery patients as a predictor of sympathetic tone ( Kusayama et al, 2019 ; He et al, 2020 ; Chen et al, 2021 ; Kutkut et al, 2021 ; Liu et al, 2021 ). However, in HD patients, the implications of SKNA have not been well elucidated.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Dynamics of Cardiac Autonomic Responses During Hemodialysis Measured by Heart Rate Variability and Skin Sympathetic Nerve Activity: The Impact of Interdialytic Weight Gain

et al. 2022

View full text Add to dashboard Cite

Background: Autonomic nervous regulation plays a critical role in end-stage kidney disease (ESKD) patients with cardiovascular complications. However, studies on autonomic regulation in ESKD patients are limited to heart rate variability (HRV) analysis. Skin sympathetic nerve activity (SKNA), which noninvasively reflects the sympathetic nerve activity, has not been used in ESKD patients.Methods: Seventy-six patients on maintenance hemodialysis (MHD) treatment (a 4-h HD session, three times a week) were enrolled. Utilizing a noninvasive, single-lead, high-frequency recording system, we analyzed the dynamic change in HRV parameters and SKNA during HD. The different characteristics between the subgroups divided based on interdialytic weight gain (IDWG, <3 kg or ≥3 kg) were also demonstrated.Results: After the HD, values for heart rate (75.1 ± 11.3 to 80.3 ± 12.3 bpm, p < 0.001) and LF/HF (1.92 ± 1.67 to 2.18 ± 2.17, p = 0.013) were significantly higher than baseline. In subgroup analysis, average voltage of skin sympathetic nerve activity (aSKNA) in IDWG ≥3 kg group was lower than the IDWG <3 kg group at the end of MHD (1.06 ± 0.30 vs 1.32 ± 0.61 μV, p = 0.046). Moreover, there was a linear correlation between mean heart rate (HR) and aSKNA in low IDWG patients (p < 0.001), which was not found in high IDWG patients. At the 1-year follow-up, high IDWG patients had a higher incidence of cardiovascular hospitalization (p = 0.046).Conclusions: In MHD patients, a gradual activation of sympathetic nerve activity could be measured by HRV and aSKNA. A lower aSKNA at the end of HD and a loss of HR-aSKNA correlation in overhydrated patients were observed. Extensive volume control is promising to improve the autonomic nervous function and clinical outcomes in this population.

show abstract

Section: Discussionmentioning

confidence: 98%

Section: Introductionmentioning

confidence: 99%

Dynamics of Cardiac Autonomic Responses During Hemodialysis Measured by Heart Rate Variability and Skin Sympathetic Nerve Activity: The Impact of Interdialytic Weight Gain

et al. 2022

View full text Add to dashboard Cite

show abstract

“…These studies further verified the feasibility of the SKNA recording to reflect the neural activity of stellate ganglion and even the activity of cardiac sympathetic nerve. Kumar et al (63) further applied SKNA recording in patients with various CVDs, such as vasovagal syncope, heart failure with decreased ejection fraction, paroxysmal atrial fibrillation, and long QT interval syndrome to explore the role of cardiac sympathetic nerve activity in the pathogenesis and development of these diseases (64)(65)(66)(67)(68)(69).…”

Section: Skin Sympathetic Nerve Activitymentioning

confidence: 99%

The Mechanism of Cardiac Sympathetic Activity Assessment Methods: Current Knowledge

Zheng

2022

Front. Cardiovasc. Med.

View full text Add to dashboard Cite

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.

show abstract

“…Repeated episodes of apnoea/hypopnea associated to a sustained reduction in oxyhaemoglobin saturation trigger acute and chronic pathological stressors, including sympathetic activation, increased blood pressure (BP) levels, endothelial dysfunction, inflammation and changes in intrathoracic pressure affecting left ventricular (LV) afterload and aortic wall transmural pressures [4][5][6]. However, the adverse impact of OSA on the cardiovascular system can be enhanced by comorbidities associated with this breathing disorder, such as obesity, metabolic disorders, hypertension, coronary heart disease, atrial fibrillation, and heart failure [7][8][9][10].…”

Section: Introductionmentioning

confidence: 99%

Is myocardial strain an early marker of systolic dysfunction in obstructive sleep apnoea? Findings from a meta-analysis of echocardiographic studies

Tadić

Gherbesi

Faggiano

et al. 2022

Journal of Hypertension

View full text Add to dashboard Cite

Aim:We investigated the association between obstructive sleep apnoea (OSA) and subclinical systolic dysfunction through a meta-analysis of echocardiographic studies that provided data on left ventricular (LV) mechanics as assessed by global longitudinal strain (GLS).Design:The PubMed, OVID-MEDLINE, and Cochrane library databases were systematically analyzed to search English-language articles published from inception to 31 December 2021. Studies were detected by using the following terms: ‘obstructive sleep apnea’, ‘sleep quality’, ‘sleep disordered breathing’, ‘cardiac damage’, ‘left ventricular hypertrophy’, ‘systolic dysfunction’, ‘global longitudinal strain’, ‘left ventricular mechanics’, ‘echocardiography’ and ‘speckle tracking echocardiography’.Results:The meta-analysis included 889 patients with OSA and 364 non-OSA controls from 12 studies. Compared with controls, GLS was significantly reduced in the pooled OSA group (SMD −1.24 ± 0.17, CI: −1.58 to −0.90, P < 0.0001), as well as in the normotensive OSA subgroup (SMD: −1.17 ± 0.12 CI:−1.40 to −0.95, P < 0.0001). Similar findings were obtained in sub-analyses performed separately in mild, moderate and severe OSA. This was not the case for LV ejection fraction (LVEF) (i.e. comparisons between controls vs. mild OSA, mild vs. moderate OSA, moderate vs. severe OSA).Conclusion:GLS is impaired in patients with OSA (independently from hypertension), worsening progressively from mild to moderate and severe forms, thus allowing to identify subclinical alterations of the systolic function not captured by LVEF. Therefore, myocardial strain assessment should be implemented systematically in the OSA setting to timely detect systolic dysfunction.

show abstract

Skin sympathetic nerve activity in patients with obstructive sleep apnea

Cited by 12 publications

References 32 publications

Dynamics of Cardiac Autonomic Responses During Hemodialysis Measured by Heart Rate Variability and Skin Sympathetic Nerve Activity: The Impact of Interdialytic Weight Gain

Dynamics of Cardiac Autonomic Responses During Hemodialysis Measured by Heart Rate Variability and Skin Sympathetic Nerve Activity: The Impact of Interdialytic Weight Gain

The Mechanism of Cardiac Sympathetic Activity Assessment Methods: Current Knowledge

Is myocardial strain an early marker of systolic dysfunction in obstructive sleep apnoea? Findings from a meta-analysis of echocardiographic studies

Contact Info

Product

Resources

About