title: Effects of endoscopic transthoracic sympathicotomy on hemodynamic and neurohumoral responses to exercise in humans.
abstract: Endoscopic transthoracic sympathicotomy (ETS) is a minimal invasive procedure of thoracic sympathetic block and has been used successfully in the treatment of primary palmar hyperhidrosis. To examine the effect of Th 2-3 ETS on hemodynamic responses to submaximal upright treadmill exercise in humans, cardiac output, plasma noradrenaline and adrenaline at rest and during the last 40s of stage 2 in a modified Bruce protocol were measured before and after ETS in 21 patients with primary palmar hyperhidrosis. Heart rate, mean arterial pressure, rate-pressure product, and noradrenaline decreased at rest and at submaximal exercise after ETS. Cardiac index at rest did not change either before or after ETS, but decreased (8.9 +/- 0.6 vs 6.8 +/- 0.4L x min(-1) m-2; p<0.01, mean +/- SEM) at submaximal exercise after ETS. Stroke index and systemic vascular resistance were similar both at rest and at submaximal exercise before and after ETS. Thus, ETS reduces myocardial oxygen demand and plasma noradrenaline levels both at rest and during exercise without significantly depressing cardiac function in terms of stroke volume.
authors.affiliation: Department of Cardiology, National Kanazawa Hospital, Ishikawa, Japan. nakay@kinbyou.hosp.go.jp
authors.forename: Yukio
authors.initials: Y
authors.lastname: Nakamura
authors.forename: Manabu
authors.initials: M
authors.lastname: Fujimoto
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Nagata
authors.forename: Ko-Ichi
authors.initials: K
authors.lastname: Shiraishi
authors.forename: Hisashi
authors.initials: H
authors.lastname: Yoshizawa
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kida
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Matsumoto
mesh_terms: D000328:Adult; D017546:Angioscopy; D001794:Blood Pressure; D004837:Epinephrine / Q000097:blood; D015444:Exercise / Q000502:physiology*; D005080:Exercise Test; D005260:Female; D006339:Heart Rate; D006439:Hemodynamics / Q000502:physiology*; D006801:Humans; D006945:Hyperhidrosis / Q000503:physiopathology* / Q000601:surgery / Q000628:therapy; D008297:Male; D009407:Nerve Block; D018377:Neurotransmitter Agents / Q000097:blood*; D009638:Norepinephrine / Q000097:blood
chemical_list: D018377:Neurotransmitter Agents; D009638:Norepinephrine; D004837:Epinephrine