Heart failure decreases nerve activity in the right atrial ganglionated plexus.
OBJECTIVE
We tested the hypothesis that heart failure (HF) results in right atrial ganglionated plexus (RAGP) denervation that contributes to sinoatrial node dysfunction.


BACKGROUND
HF is associated with sinoatrial node dysfunction. However, the detailed mechanisms remain unclear.


METHODS
We recorded nerve activity (NA) from the RAGP, right stellate ganglion (SG), and right vagal nerve in 7 ambulatory dogs at baseline and after pacing-induced HF. We also determined the effects of RAGP stimulation in isolated normal and HF canine RA.


RESULTS
NAs in both the SG and vagal were significantly higher in HF than at baseline. The relationship between 1-minute integrated NAs of vagal and RAGP showed either a positive linear correlation (Group 1, n = 4) or an L-shaped correlation (Group 2, n = 3). In all dogs, a reduced heart rate was observed when vagal-NA was associated with simultaneously increased RAGP-NA. On the other hand, when vagal-NA was not associated with increased RAGP-NA, the heart rate was not reduced. The induction of HF significantly decreased RAGP-NA in all dogs (P < 0.05). Stimulating the superior RAGP in isolated RA significantly reduced the sinus rate in normal but not the HF hearts. Immunohistochemical staining revealed lower densities of tyrosine hydroxylase- and choline acetyltransferase-positive nerve tissues in HF RAGP than normal (P < 0.001 and P = 0.001, respectively).


CONCLUSIONS
The RAGP-NA is essential for the vagal nerve to counterbalance the SG in sinus rate control. In HF, RAGP denervation and decreased RAGP-NA contribute to the sinus node dysfunction.
Division of Cardiology, Department of Medicine, Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
Tetsuji
T
Shinohara
Mark J
MJ
Shen
Seongwook
S
Han
Mitsunori
M
Maruyama
Hyung-Wook
HW
Park
Michael C
MC
Fishbein
Changyu
C
Shen
Peng-Sheng
PS
Chen
Shien-Fong
SF
Lin
D000200:Action Potentials; D000818:Animals; D002304:Cardiac Pacing, Artificial; D002795:Choline O-Acetyltransferase / Q000378:metabolism; D004195:Disease Models, Animal; D004285:Dogs; D004562:Electrocardiography; D006325:Heart Atria / Q000294:innervation; D006333:Heart Failure / Q000209:etiology / Q000378:metabolism / Q000503:physiopathology*; D006339:Heart Rate; D007150:Immunohistochemistry; D008297:Male; D012849:Sinoatrial Node / Q000294:innervation*; D013233:Stellate Ganglion / Q000201:enzymology / Q000503:physiopathology*; D013997:Time Factors; D014446:Tyrosine 3-Monooxygenase / Q000378:metabolism; D014630:Vagus Nerve / Q000201:enzymology / Q000503:physiopathology*; D056969:Voltage-Sensitive Dye Imaging
D014446:Tyrosine 3-Monooxygenase; D002795:Choline O-Acetyltransferase