Clinical Medicine Insights: Pathology

Sympathetic hyperinnervation due to nerve sprouting generated by the left stellate ganglion has been noted following cardiopulmonary disease processes. Sympathetic hyperinnervation seems to be limited to cardiopulmonary diseases in the experimental and clinical settings. However, histological changes of the left stellate ganglion following cardiopulmonary diseases in humans have yet to be observed. This study intends to investigate the histological changes of cadaveric sympathetic nervous tissue of left stellate ganglia (n = 32) and their relationship to noted pathology. Our study found fibrotic changes of the left stellate ganglion are not significantly dependent upon pathological processes, however, changes in the number of nerve cell bodies seems to be pathology dependent. A relationship between respiratory (mean = 33.3; P = 0.023) and cardiovascular pathologies (mean = 29.6; P = 0.199) and an increase in nerve cell bodies of the left stellate ganglion was noted when compared to other pathologies (mean = 25.7). The link between cardiopulmonary disease and sympathetic hyperinnervation may be the increase in the number of nerve cell bodies of the left stellate ganglion. Our results are clinically significant considering sympathetic hyperinnervation is associated with arrythmogenesis and an increase in morbidity and mortality in patients with pulmonary disease. Such findings may warrant investigation into the use of ganglion blockade in cardiopulmonary diseases.