title: Left stellate ganglion block has only small effects on left ventricular function in awake dogs before and after induction of heart failure.
abstract: Left stellate ganglion block (LSGB) results in acute sympathetic denervation of the left ventricular (LV) posterobasal wall. We investigated the effects of LSGB in chronically instrumented awake dogs before and after the induction of pacing-induced congestive heart failure. Twelve dogs were instrumented for measurement of global hemodynamics [LV pressure (LVP)], its first derivative (dP/dt), cardiac output (CO), and regional myocardial function (systolic posterobasal segment length shortening, mean velocity [SLmv]). Before the induction of heart failure (n = 12), LSGB did not affect CO [3.2+/-1.4 (control, mean +/- SD) vs. 3.3+/-1.6 L/min (LSGB, P = 0.45)] and SLmv (11.1+/-4.0 vs. 10.8+/-4.0 mm/s, P = 0.16), but slightly reduced LVP (130+/-12 vs. 125+/-14 mm Hg, P = 0.04), dP/dt(max) (3614+/-755 vs. 3259+/-644 mm Hg/s, P = 0.003) and dP/dt(min) (-3153+/-663 vs. -2970+/-725 mm Hg/s, P = 0.03). During heart failure (n = 8), global hemodynamics [CO (2.8+/-1.2 vs. 2.7+/-1.2 L/min, P = 0.04), LVP (119+/-6 vs. 112+/-9 mm Hg, P = 0.01), dP/dt(max) (1945+/-520 vs. 1824+/-554 mm Hg/s, P = 0.03) and dP/dt(min) (-2402+/-678 vs. -2243+/-683 mm Hg/s, P = 0.04)], as well as regional myocardial function, were significantly different after LSGB [SLmv] (8.0+/-3.8 vs. 6.9+/-3.4 mm/s, P = 0.02)]. In conclusion, even during heart failure, the hemodynamic changes after LSGB are small, confirming its broad margin of safety.
authors.affiliation: Institut für Herz- und Kreislaufphysiologie and Institut für Klinische Anaesthesiologie, Heinrich-Heine-Universität, Düsseldorf, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Müllenheim
authors.forename: B
authors.initials: B
authors.lastname: Preckel
authors.forename: D
authors.initials: D
authors.lastname: Obal
authors.forename: M
authors.initials: M
authors.lastname: Heiderhoff
authors.forename: J
authors.initials: J
authors.lastname: Hoff
authors.forename: V
authors.initials: V
authors.lastname: Thämer
authors.forename: W
authors.initials: W
authors.lastname: Schlack
mesh_terms: D000779:Anesthetics, Local / Q000008:administration & dosage; D000818:Animals; D001340:Autonomic Nerve Block; D001794:Blood Pressure / Q000502:physiology; D002302:Cardiac Output / Q000502:physiology; D002304:Cardiac Pacing, Artificial; D003243:Consciousness; D003971:Diastole; D004285:Dogs; D005260:Female; D006333:Heart Failure / Q000503:physiopathology*; D006339:Heart Rate / Q000502:physiology; D006352:Heart Ventricles / Q000294:innervation; D008012:Lidocaine / Q000008:administration & dosage; D016014:Linear Models; D009200:Myocardial Contraction / Q000502:physiology; D013233:Stellate Ganglion; D013599:Systole; D014655:Vascular Resistance / Q000502:physiology; D016277:Ventricular Function, Left / Q000502:physiology*; D017725:Ventricular Pressure / Q000502:physiology
chemical_list: D000779:Anesthetics, Local; D008012:Lidocaine