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. 2010 Jun;33(6):E16-21.
doi: 10.1002/clc.20676.

Improving myocardial perfusion by percutaneous coronary intervention reduces central sympathetic activity in stable angina

Marc E Gomes  1 , Wim R Aengevaeren, Jacques W Lenders, Freek W Verheugt, Paul Smits, Cees J Tack
Affiliations

Improving myocardial perfusion by percutaneous coronary intervention reduces central sympathetic activity in stable angina

Marc E Gomes et al. Clin Cardiol. 2010 Jun.

Abstract

Background: By stimulating sympathetic afferents, repetitive myocardial ischemia induces a state of increased sympathetic tone.

Hypothesis: Removing the ischemic trigger by revascularization using percutaneous coronary intervention (PCI) might thus reduce central sympathetic activity in symptomatically stable angina patients.

Methods: A total of 20 patients with stable angina > or = New York Heart Association (NYHA) class II with persistent symptoms despite maximal pharmacological therapy and a clinical indication for PCI, were included in our study. Sympathetic nervous system activity was measured before and 1 month after PCI by a combination of techniques: direct muscle sympathetic nerve activity (MSNA), neurochemical (plasma catecholamine levels), and heart rate variability (HRV).

Results: All patients completed the study. After PCI there was a significant reduction in MSNA (pre-PCI 72 +/- 4 to post-PCI 53 +/- 4 burst/100 beats, P < .05) and low frequency/high frequency (LF/HF) ratio (3.7 +/- 0.6 vs 2.4 +/- 0.4, P < .05) consistent with a decline in sympathetic activity. Plasma norepinephrine levels were reduced after PCI, but this difference did not reach statistical significance (1.84 +/- 0.17 vs 1.73 +/- 0.13 nmol/L, P = not significant).

Conclusion: Coronary revascularization by PCI reduces sympathetic activity in patients with established myocardial ischemia.

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