Left stellate stimulation increases left ventricular ejection fraction in patients with essential palmar hyperhidrosis.
Left stellate stimulation increases cardiac contractility, heart rate, systolic blood pressure, and QT interval in experimental animals. To see if these changes occur in humans, we stimulated the left stellate ganglia with a monopolar coagulation power of 5 W in 10 patients with palmar hyperhidrosis, axillar hyperhidrosis, or both. We also stimulated the right stellate ganglia of the other 10 patients. The mean left ventricular ejection fraction (LVEF, measured with M-mode echocardiography), QT interval, heart rate and systolic blood pressure of the baseline were 54.72%, 403 ms, 65/min, and 115 mmHg, whereas those after 45 s of left stellate stimulation were 62.84%, 434 ms, 73/min, and 123 mmHg respectively. We compared these data with those of the baseline and the two-tailed P values were 0.005 for both LVEF and QT interval, 0.052 for heart rate, and 0.050 for systolic blood pressure respectively (Wilcoxon Matched-Pairs Signed-Ranks Test). The corresponding P-values for those of the right stellate stimulation were 0.721, 0.203, 0.260, and 0.326 respectively. All these suggest that the left stellate ganglia predominate the right ones in affecting LVEF, QT interval, heart rate and systolic blood pressure in humans, that left stellate stimulation increases LVEF and prolongs QT interval significantly, and that left stellate stimulation accelerates heart rate and elevates systolic blood pressure marginally.
Wong
C W
CW
Division of Neurosurgery, Chang Gung Memorial Hospital at Keelung, Taiwan. c1951@netvigator.com
Wang
C H
CH
D000328:Adult; D001794:Blood Pressure; D004558:Electric Stimulation; D005260:Female; D006321:Heart / Q000294:innervation / Q000502:physiology; D006801:Humans; D006945:Hyperhidrosis / Q000503:physiopathology* / Q000601:surgery; D008297:Male; D013233:Stellate Ganglion / Q000502:physiology*; D013318:Stroke Volume / Q000502:physiology*; D013562:Sympathectomy; D016277:Ventricular Function, Left / Q000502:physiology*