Left Stellate Ganglion Ablation Inhibits Ventricular Arrhythmias through Macrophage Regulation in Canines with Acute Ischemic Stroke

Figures

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  Figure 1. A head MRI that was performed 24 hours after MCAO suggested the right temporal lobe infarction, marked by red rectangles. (A) and (C) Coronal MRI scan of the sham-operated group in T2WI and DWI respectively. (B) and (D) Coronal MRI scan of the AS group in T2WI and DWI respectively. Abbreviations: AS: acute stroke; SGA: stellate ganglion ablation; MCAO: middle cerebral artery occlusion; MRI: magnetic resonance imaging; T2WI: T2 weighted imaging; DWI: diffusion weighted imaging.

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  Figure 2. Differences in (A) the ventricular ERPs and (B) the dERP in all the groups. (A) The ERPs at all recording sites in the AS group were significantly reduced than those in the sham-operated group and the SGA group. The ERPs at RVB, LVB and LVFW were lower in the SGA group than those in the sham-operated group. However, there were no significant difference in ERPs at RVFW, RVA and LVA between the sham-operated group and the SGA group. *P<0.05; #P<0.05; ▲P<0.05. (B) The dERP in the AS group was significantly increased than that in the sham-operated group and the SGA group. The dERP was higher in the SGA group than that in the sham-operated group. ***P<0.001; #P<0.05; ▲▲P<0.01. Abbreviations: AS: acute stroke; SGA: stellate ganglion ablation; ERPs: effective refractory periods; dERP: dispersion of effective refractory period; RVA: right ventricular epicardium at the apex; RVFW: right ventricular epicardium at the free wall; RVB: right ventricular epicardium at the base; LVA: left ventricular epicardium at the apex; LVFW: left ventricular epicardium at the free wall; LVB: left ventricular epicardium at the base.

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  Figure 3. The number of (B) spontaneous VPB, (C) VT inducibility and (D) VFH in all the groups. (A) Examples of VPB, VT and VF occurrence. (B) The number of spontaneous VPB during the monitoring was increased than that in the sham-operated group and the SGA group. The SGA group had a higher number of VPB than the sham-operated group, but there was no statistical significant. **P<0.01; ▲▲P<0.01. (C) VT was induced in 1 canine in the sham-operated group (1/6), 6 canines in the AS group (6/7) and 2 canines in the SGA group (2/7). No VF was induced in all the groups. (D) The AS group had an significantly reduced VFH than the sham-operated group and the SGA group. Compared with that in the sham-operated group, the VFH in the SGA group was lower. ***P<0.001; #P<0.05; ▲▲▲P<0.001. Abbreviations: AS: acute stroke; SGA: stellate ganglion ablation; VPB: ventricular premature beat; VT: ventricular tachycardia; VF: ventricular fibrillation; VFH: ventricular fibrillation threshold.

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  Figure 4. (A) Examples of LSG activity 3 days after operation. (B) The frequency and (C) the amplitude in the AS group were greatly elevated compared with those in the sham-operated group. ***P<0.001. Abbreviations: LSG: left stellate ganglion; AS: acute stroke.

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  Figure 5. (A) The immunofluorescence of pro-inflammatory M1 macrophages in ventricle. (B) the number of pro-inflammatory M1 macrophages in ventricle was significantly increased in the AS group than that in the sham-operated group and the SGA group. The SGA group had a higher number of M1 macrophages in ventricle compared with the sham-operated group. (C) The relative levels of iNOS mRNA in ventricle were significantly increased in the AS group than those in the sham-operated group and the SGA group. The SGA group had higher levels of iNOS mRNA in ventricle compared with the sham-operated group. ***P<0.001; ##P<0.01; ▲▲▲P<0.001. Abbreviations: AS: acute stroke; SGA: stellate ganglion ablation; iNOS: inducible nitric oxide synthase.

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  Figure 6. (A) The levels of MCP-1 and (D) TNF-α in ventricle were significantly increased in the AS group, compared with those in the sham-operated group and the SGA group. The SGA group had higher levels of MCP-1 and TNF-α in ventricle than the sham-operated group. ***P<0.001; ##P<0.01; ▲▲▲P<0.001. (B) and (D) The Western blotting results of MCP-1 and TNF-α in ventricle. Abbreviations: AS: acute stroke; SGA: stellate ganglion ablation; MCP-1: monocyte chemotactic protein-1; TNF-α: tumour necrosis factor-alpha.

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  Figure 7. (A) The expression of NF-κB P65 protein in ventricle was significantly elevated in the AS group, compared with that in the sham-operated group and the SGA group. The SGA group had a higher expression of NF-κB P65 protein in ventricle than the sham-operated group. ***P<0.001; ##P<0.01; ▲▲▲P<0.001. (B) The Western blotting results of NF-κB P65 protein in ventricle. Abbreviations: AS: acute stroke; SGA: stellate ganglion ablation.