RESUMEN
In this paper we highlight the presence of tachycardia in post-acute COVID-19 syndrome by introducing a new label for this phenomenon-post-COVID-19 tachycardia syndrome-and argue that this constitutes a phenotype or sub-syndrome in post-acute COVID-19 syndrome. We also discuss epidemiology, putative mechanisms, treatment options, and future research directions in this novel clinical syndrome.
Asunto(s)
COVID-19/complicaciones , Taquicardia Sinusal , COVID-19/fisiopatología , COVID-19/terapia , Humanos , Fenotipo , SARS-CoV-2 , Síndrome , Taquicardia Sinusal/etiología , Taquicardia Sinusal/genética , Taquicardia Sinusal/fisiopatología , Taquicardia Sinusal/cirugía , Síndrome Post Agudo de COVID-19Asunto(s)
Mutación con Ganancia de Función/genética , Canales Regulados por Nucleótidos Cíclicos Activados por Hiperpolarización/genética , Proteínas Musculares/genética , Canales de Potasio/genética , Taquicardia Sinusal/genética , AMP Cíclico/fisiología , Femenino , Células HEK293 , Humanos , Canales Regulados por Nucleótidos Cíclicos Activados por Hiperpolarización/química , Canales Regulados por Nucleótidos Cíclicos Activados por Hiperpolarización/fisiología , Masculino , Proteínas Mutantes/metabolismo , Miocitos Cardíacos/metabolismo , Miocitos Cardíacos/fisiología , Linaje , Recurrencia , Síncope/genéticaRESUMEN
BACKGROUND: Hyperactivity of the cardiac sympathetic nervous system may underlie the pathogenesis of inappropriate sinus tachycardia (IST). Studies have proven that cervical vagal stimulation could inhibit stellate ganglion neural activity. SUBJECTS: To investigate whether noninvasive vagal nerve stimulation (NVNS) could inhibit sympathetically induced sinus node acceleration by reducing right stellate ganglion (RSG) neural activity. METHODS: Sixteen anesthetized dogs were randomly divided into NVNS group (with NVNS, n = 8) and control group (with sham NVNS, n = 8). NVNS was delivered to the vagus nerve innervating at the right tragus with a voltage of 80% below the threshold, the minimal voltage to slow the sinus rate or atrioventricular conduction. The maximal sinus rate accelerations induced by high-frequency stimulation (HFS) of RSG and RSG neural activity were measured at baseline and 3 hours after NVNS. At the end, SK2, c-fos, and NGF protein expression in RSG were examined in both groups. RESULTS: Compared to baseline, the maximal sinus node acceleration induced by RSG stimulation and the RSG neural activity were both significantly attenuated after 3 hours of NVNS (P < 0.05 for both). However, these indices did not change significantly in the control group (P > 0.05). SK2 expression in RSG was significantly higher and c-fos and NGF expressions were significantly lower in the NVNS group than those in the control group (P < 0.05). CONCLUSION: Noninvasive vagal nerve stimulation may suppress RSG activity possibly by modulating SK2, c-fos, and NGF expressions in RSG, thus inhibiting sympathetically induced sinus node acceleration.
Asunto(s)
Frecuencia Cardíaca , Nodo Sinoatrial/inervación , Ganglio Estrellado/fisiopatología , Taquicardia Sinusal/terapia , Estimulación del Nervio Vago/métodos , Animales , Modelos Animales de Enfermedad , Perros , Factor de Crecimiento Nervioso/genética , Factor de Crecimiento Nervioso/metabolismo , Proteínas Proto-Oncogénicas c-fos/genética , Proteínas Proto-Oncogénicas c-fos/metabolismo , ARN Mensajero/genética , ARN Mensajero/metabolismo , Canales de Potasio de Pequeña Conductancia Activados por el Calcio/genética , Canales de Potasio de Pequeña Conductancia Activados por el Calcio/metabolismo , Ganglio Estrellado/metabolismo , Taquicardia Sinusal/etiología , Taquicardia Sinusal/genética , Taquicardia Sinusal/metabolismo , Taquicardia Sinusal/fisiopatología , Factores de TiempoRESUMEN
Proteus syndrome is an overgrowth syndrome principally affecting cutaneous and skeletal tissues, accompanied by subcutaneous hamartomas. We report on a patient with predominantly skeletal and visceral involvement, including a cardiac mass and thickening of the myocardial septum affecting cardiac conduction and contraction.