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Titolo:
Spinal cord stimulation for chronic intractable angina pectoris: A unifiedtheory on its mechanism
Autore:
Latif, OA; Nedeljkovic, SS; Stevenson, LW;
Indirizzi:
Harvard Univ, Brigham & Womens Hosp, Sch Med, Dept Med,Cardiovasc Div, Boston, MA 02115 USA Harvard Univ Boston MA USA 02115 Med,Cardiovasc Div, Boston, MA 02115 USA Harvard Univ, Brigham & Womens Hosp, Sch Med, Dept Anesthesia Perioperat &Pain Med, Boston, MA 02115 USA Harvard Univ Boston MA USA 02115 rioperat &Pain Med, Boston, MA 02115 USA
Titolo Testata:
CLINICAL CARDIOLOGY
fascicolo: 8, volume: 24, anno: 2001,
pagine: 533 - 541
SICI:
0160-9289(200108)24:8<533:SCSFCI>2.0.ZU;2-N
Fonte:
ISI
Lingua:
ENG
Soggetto:
ELECTRICAL NERVE-STIMULATION; HEART-RATE-VARIABILITY; CORONARY BLOOD-FLOW; ADENOSINE RECEPTOR ACTIVATION; DORSAL COLUMN STIMULATION; GENE-RELATED PEPTIDE; TACTILE HYPERSENSITIVITY; MONONEUROPATHIC RATS; MYOCARDIAL-ISCHEMIA; PAIN;
Keywords:
angina; syndrome X; spinal cord stimulation; ischemia; autonomic nervous system; myocardial blood flow; gamma aminobutyric acid; spinothalamic tract;
Tipo documento:
Review
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
58
Recensione:
Indirizzi per estratti:
Indirizzo: Latif, OA Brigham & Womens Hosp, Dept Anesthesiol Perioperat & Pain Med, 75 Francis St, Boston, MA 02115 USA Brigham & Womens Hosp 75 Francis St Boston MA USA 02115 2115 USA
Citazione:
O.A. Latif et al., "Spinal cord stimulation for chronic intractable angina pectoris: A unifiedtheory on its mechanism", CLIN CARD, 24(8), 2001, pp. 533-541

Abstract

The use of spinal cord stimulation (SCS) for chronic intractable anginal pain was first described in 1987. Numerous studies have demonstrated its efficacy in improving exercise tolerance, decreasing frequency of anginal episodes, and prolonging time to electrocardiographic signs of ischemia. This review will examine the potential mechanisms of this antianginal effect and propose a unified hypothesis explaining it. The effect of SCS involves a mutual interaction of decreased pain, decreased sympathetic tone, and a likely redistribution of myocardial blood flow to ischemic regions. Spinal cord stimulation reduces the transmission of nociceptive impulse via the spinothalamic tract due to an enhanced release of gamma aminobutyric acid (GABA) from dorsal hom interneurons. Improvement of myocardial blood flow at the microvascular level has been demonstrated by positron emission tomography (PET). A decreased sympathetic tone has been shown by norepinephrine kinetics,tests of sympathetic reflexes, and the use of ganglionic blockers. We hypothesize that SCS exerts its beneficial effects by decreasing pain and decreasing sympathetic tone, the result of which is decreased myocardial oxygen consumption along with an improved myocardial microcirculatory blood flow.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 28/09/20 alle ore 15:24:11