Sympathetic Nervous System Analysis for Coronary Artery Dissection
Recruiting in Palo Alto (17 mi)
Age: 18+
Sex: Female
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: Mayo Clinic
Must not be taking: Anticoagulants, Antiplatelets
Disqualifiers: Pregnancy, Unstable cardiac, Prisoner, others
No Placebo Group
Trial Summary
What is the purpose of this trial?
This trial compares the stress response and artery health of people who have had a heart artery tear to those who haven't. Researchers will measure how well their body's stress system works and how healthy their arteries are.
Will I have to stop taking my current medications?
The trial does not specify if you need to stop taking your current medications, but you cannot participate if you are actively being treated with anticoagulation (blood thinners) or dual antiplatelet therapy (medications that prevent blood clots).
What data supports the effectiveness of the treatment Sympathetic Nervous System Analysis for Coronary Artery Dissection?
Research shows that the sympathetic nervous system plays a crucial role in regulating circulation and is involved in cardiovascular diseases. Understanding and analyzing this system can help in developing new therapeutic strategies, which may be beneficial for conditions like coronary artery dissection.12345
Is the Sympathetic Nervous System Analysis generally safe for humans?
The axillary sympathectomy, a surgical approach to the sympathetic nervous system, is generally safe with a smooth recovery, though some temporary side effects like Horner's Syndrome (drooping eyelid and small pupil), pneumothorax (collapsed lung), and hemothorax (blood in the chest cavity) can occur but are avoidable.12367
How does the treatment for coronary artery dissection differ from other treatments?
This treatment focuses on analyzing the sympathetic nervous system (SNS), which is involved in regulating blood flow and heart function. Unlike other treatments that may not directly target the SNS, this approach uses techniques like microneurography to assess and potentially modulate SNS activity, offering a novel way to address the condition.158910
Eligibility Criteria
This study is for individuals with a history of spontaneous coronary artery dissection (SCAD), confirmed by specific heart imaging tests, and healthy volunteers without any cardiac disease. Pregnant women, those with unstable heart conditions recently, or on certain blood thinners can't participate.Inclusion Criteria
My SCAD diagnosis was confirmed through specific heart imaging tests.
I have never had heart disease.
Exclusion Criteria
I have not had any heart problems in the last month.
Pregnancy
Prisoner
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Trial Timeline
Screening
Participants are screened for eligibility to participate in the trial
2-4 weeks
Diagnostic Assessment
Participants undergo a series of diagnostic studies to assess neurovascular function
Baseline
Follow-up
Participants are monitored for safety and effectiveness after diagnostic assessments
4 weeks
Treatment Details
Interventions
- Sympathetic Nervous System Analysis (Behavioural Intervention)
Trial OverviewThe trial investigates the sympathetic nervous system's activity (our body's fight or flight response) and arterial health in SCAD patients compared to healthy people using non-invasive tests like echocardiograms and carotid ultrasounds.
Participant Groups
2Treatment groups
Experimental Treatment
Group I: Spontaneous coronary artery dissection (SCAD) groupExperimental Treatment6 Interventions
Subject with a history of SCAD will undergo a series of diagnostic studies to assess neurovascular function.
Group II: Healthy Control GroupExperimental Treatment6 Interventions
Healthy subjects will undergo a series of diagnostic studies to assess neurovascular function.
Find a Clinic Near You
Research Locations NearbySelect from list below to view details:
Mayo Clinic RochesterRochester, MN
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Who Is Running the Clinical Trial?
Mayo ClinicLead Sponsor
National Heart, Lung, and Blood Institute (NHLBI)Collaborator
References
Axillary sympathectomy for upper extremities. [2019]Among the several various surgical approaches to the cervico-dorsal sympathetic system, the axillary approach seems to us the operation of choice. The operation is simple, gives excellent access to the required sympathetic ganglions, including the lower part of the stellate ganglion, down to the fifth thoracic ganglion. In all cases the sympathectomy was clinically complete. The postoperative course was mostly smooth, and the few cases of transient Horner's Syndrome, pneumothorax and hemothorax could have been avoided.
Branches of the thoracic sympathetic trunk in the human fetus. [2019]The segmental organization of the thoracic sympathetic trunk and all its ramifications was studied in 6 human fetuses (16-22 weeks) by means of the acetylcholinesterase in toto staining method. Each trunk was divided into 12 sympathetic segments. A segment is defined as that part of the sympathetic trunk which is connected via its rami communicantes with one spinal nerve, without discriminating between grey and white rami. The diameter of the rami communicantes and their direction towards the spinal nerves are variable. The number of peripheral segmental ramifications of the trunk is much larger than assumed previously. Each thoracic sympathetic segment gives off at least 4-5 nerves. Three categories of nerves are discerned: (1) large splanchnic rootlets confined to the greater, lesser and least thoracic splanchnic nerves, (2) medium-sized splanchnic nerves directed towards thoracic viscera, some of which give off branches towards costovertebral joint plexuses and, described for the first time in man, (3) small nerves which ramify extensively and form nerve plexuses in the capsule of the costovertebral joints. The majority of the ramifications is formed by the nerves of the third category. The existence of Kuntz's nerve, connecting the 2nd intercostal nerve and 1st thoracic spinal nerve, is confirmed in four specimens. The nerve plexuses of the costovertebral joints receive a segmentally organized innervation: they receive their input from the neighbouring sympathetic segment and the one cranial to it. It is concluded that the thoracic sympathetic branches in man show a complex, segmentally organized pattern and may have a considerable component of somatosensory nerve fibers. The complex relationships must be taken into account in surgical sympathectomies.
Cardiac sympathetic neuroimaging: summary of the First International Symposium. [2021]The First International Symposium on Cardiac Sympathetic Neuroimaging brought together for the first time clinical and preclinical researchers evaluating autonomic and neurocardiologic disorders by this modality. The invited lectures and posters presented some uses of cardiac sympathetic neuroimaging for diagnosis, prognosis, and monitoring treatments. The Symposium also included a discussion about whether and how to expand the availability of cardiac sympathetic neuroimaging at medical centers in the United States. Here, we review the background for the Symposium, provide an annotated summary of the lectures and posters, discuss some of the take-home points from the roundtable discussion, and propose a plan of action for the future.
Topographical considerations under video-scope guidance in the T3,4 levels sympathetic surgery. [2016]Anatomical variation of the sympathetic nervous system is known to be one of the main causes of failure and dissatisfaction after sympathetic surgery. However, there are only few reports on the descriptive analysis of sympathetic nerve variants. The purpose of this study is to investigate the anatomical variations of the sympathetic trunk at the levels of T3 and T4 ganglia considered in a topographic approach for sympathetic procedures and to further improve the postoperative outcome.
[Sympathy and heartache: new information on the sympathetic nervous system]. [2007]The sympathetic nervous system is an important regulator of the circulation. Interactions with other regulating systems, e.g. the renin angiotensin system, play important roles. By means of microneurography, sympathetic activity in humans can be assessed directly in the nerve. Insights into the dynamic regulation of the circulation under physiological and pathophysiological conditions are possible. Activation of the sympathetic nervous system in cardiovascular diseases affects course, prognosis, and therapy. Prognosis in heart failure depends on sympathetic activation, which can be decreased by inhibition of angiotensin II synthesis by ACE-inhibitors. In contrast to nitrates, these drugs do not increase sympathetic activity. The sympathetic nervous system is also heavily involved in the pathogenesis of hypertension. Borderline hypertensives and offspring of hypertensive parents show increased sympathetic nerve activities. Investigation of the sympathetic nervous system under physiological and pathophysiological conditions may serve as a basis for new therapeutic strategies.
The lumbar sympathetic. Anatomy and surgical implications. [2005]The ganglionated lumbar sympathetic chains lie on the lateral aspects of the bodies of the lumbar vertebrae and not more laterally as in the thorax where the chain lies in relation to the heads and necks of the ribs. Lumbar ganglia vary in number. They are best numbered according to the spinal nerve to which the particular ganglion sends its postganglionic fibers, but, at operation, the surgeon is unable to obtain this kind of information. It is customary to mark the extent of resection by the application of a dura clip to the proximal and distal ends of the trunk. Roentgenographic visualization later can approximate the level of resection in relation to the vertebrae. Anomalies can lead to unsuccessful denervation of the lower extremities. These include extraganglionic connecting sympathetic nerve trunks, intermediate ganglia, and cross-over fibers connecting the right and left lumbar sympathetic trunks usually at the level of the fourth and fifth lumbar segments, but anatomically sometimes as high as the third and second. Specific complications of lumbar sympathectomy include failure of adequate denervation, brief paralytic ileus, hyperidrosis in parts of the body which remain normally innervated, sexual dysfunction, and post-sympathectomy neuralgia.
Blood supply of the human cervical sympathetic chain and ganglia. [2019]Cadaveric studies of the blood supply to the human cervical sympathetic chain and ganglia are lacking in the English literature. This study seeks to elucidate the gross blood supply of the cervical sympathetic chain so as to avoid surgical disruption of these vessels and thus decrease the risk of vascular insufficieny and subsequent dysfunction of thoracolumbar autonomic outflow to the head and neck.
[Effect of bilateral superior cervical sympathetic ganglion occlusion on pathological process of aortic dissection and its mechanism]. [2023]To investigate the effect of bilateral superior cervical sympathetic ganglion occlusion (SCG) on aortic dissection and its possible mechanism.
Anatomical variations of the upper thoracic sympathetic chain: a review. [2022]The objective of this study is to provide a thorough overview of the anatomical variations of the upper thoracic sympathetic trunk to improve clinical results of upper thoracic sympathectomy. In addition, this study strives for standardization of future studies regarding the anatomy of the upper thoracic sympathetic chain.
Direct evidence of sympathetic hyperactivity in patients with vasospastic angina. [2020]The autonomic nervous system is reported to be involved in the pathogenesis of vasospastic angina (VSA). Studies based on heart rate variability analysis have shown conflicting results with both a reduction and an enhancement of sympathetic nervous system (SNS) activity in patients with Prinzmetal's variant angina, but direct assessment has never been performed. The aim of our study was to evaluate the SNS activity using microneurography in patients with VSA.