Autonomic Nervous System, Sudden Cardiac Death, and Related Diseases
自律神経および心臓突然死に絡む関連疾患

座 長 池田 隆徳 東邦大学大学院医学研究科 循環器内科学
David G. Benditt University of Minnesota Medical School

This session highlights the influence of the autonomic nervous system (ANS) in the sudden cardiac death (SCD). In Japan, SCD is a major public health problem, accounting for 70,000 deaths annually. The problem of SCD remains a huge public health issue. Currently, left ventricular ejection function (LVEF) have been shown to be predictive of cardiac mortality in patients with myocardial infarction (MI) or idiopathic/secondary dilated cardiomyopathy (CM). It is clear that there is a prominent autonomic influence on the occurrence of SCD. Evidence from clinical studies points to a prominent role of autonomic activation in SCD. Previous clinical trials established that β-blocker therapy in patients surviving acute MI was highly effective in reducing overall mortality and SCD, and this has now become the standard of care. Markers of activation of the ANS including heart rate variability (HRV) and baroreflex sensitivity (BRS), have been shown to be sensitive markers of mortality in patients with ischemic heart failure. Other markers that reflect partially autonomic abnormality, such as heart rate turbulence (HRT), have been also introduced as useful markers in identifying patients at risk of cardiac mortality. Use of β-blockers has shown to reduce mortality in patients with MI or dilated CM. Thus, the development of new therapies by modulating ANS, may result in reduced risk for health issue. In this symposium, we would like to widely discuss focusing on ANS, SCD, and related cardiac diseases.