Sudden cardiac deaths have higher proportion of left stellate ganglionitis
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Sudden cardiac deaths have higher proportion of left stellate ganglionitis. / Tse, Rexson; Garland, Jack; McCarthy, Sinead; Ondruschka, Benjamin; Bardsley, Emma N; Wong, Christopher X; Stables, Simon; Paton, Julian F R.
In: FORENSIC SCI MED PAT, Vol. 18, No. 2, 06.2022, p. 156-164.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Sudden cardiac deaths have higher proportion of left stellate ganglionitis
AU - Tse, Rexson
AU - Garland, Jack
AU - McCarthy, Sinead
AU - Ondruschka, Benjamin
AU - Bardsley, Emma N
AU - Wong, Christopher X
AU - Stables, Simon
AU - Paton, Julian F R
N1 - © 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
PY - 2022/6
Y1 - 2022/6
N2 - One of the hypothesized mechanisms of sudden cardiac death in humans is an arrhythmia precipitated by increased sympathetic outflow to a compromised heart. The stellate ganglia provide the main sympathetic innervation to the heart, where the left stellate ganglion appears to play a role in arrhythmogenesis. Case reports of sudden cardiac death have described left stellate ganglion inflammation but no larger studies have been performed. Thus, we have specifically assessed whether the left stellate ganglion was inflamed in those dying from sudden cardiac death versus other causes of death. Thirty-one left stellate ganglia were resected from cadavers diagnosed with sudden cardiac deaths and compared with 18 ganglia from cadavers diagnosed with non-sudden cardiac deaths. Ganglia were stained with hematoxylin and eosin and lymphocytic aggregates compared. The proportion of left stellate ganglion inflammation (77%) was significantly higher in deaths from sudden cardiac deaths than non-sudden cardiac deaths (33%). This study provides information on a previously recognized, but understudied, structure that may help understand sudden cardiac death. We found high prevalence of stellate ganglion inflammation and propose that this may trigger sympathetic storms.
AB - One of the hypothesized mechanisms of sudden cardiac death in humans is an arrhythmia precipitated by increased sympathetic outflow to a compromised heart. The stellate ganglia provide the main sympathetic innervation to the heart, where the left stellate ganglion appears to play a role in arrhythmogenesis. Case reports of sudden cardiac death have described left stellate ganglion inflammation but no larger studies have been performed. Thus, we have specifically assessed whether the left stellate ganglion was inflamed in those dying from sudden cardiac death versus other causes of death. Thirty-one left stellate ganglia were resected from cadavers diagnosed with sudden cardiac deaths and compared with 18 ganglia from cadavers diagnosed with non-sudden cardiac deaths. Ganglia were stained with hematoxylin and eosin and lymphocytic aggregates compared. The proportion of left stellate ganglion inflammation (77%) was significantly higher in deaths from sudden cardiac deaths than non-sudden cardiac deaths (33%). This study provides information on a previously recognized, but understudied, structure that may help understand sudden cardiac death. We found high prevalence of stellate ganglion inflammation and propose that this may trigger sympathetic storms.
KW - Arrhythmias, Cardiac
KW - Cadaver
KW - Death, Sudden, Cardiac/etiology
KW - Heart
KW - Humans
KW - Inflammation/complications
KW - Sympathetic Nervous System
U2 - 10.1007/s12024-022-00466-5
DO - 10.1007/s12024-022-00466-5
M3 - SCORING: Journal article
C2 - 35349080
VL - 18
SP - 156
EP - 164
JO - FORENSIC SCI MED PAT
JF - FORENSIC SCI MED PAT
SN - 1547-769X
IS - 2
ER -
