Assessment and visualization of neuronal remodeling in association with various cardiovascular conditions
Araujo, Amanda G.
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It has been reported in previous works that there is a greater neuron density in the stellate ganglion of patients with cardiovascular disease. However, an analysis of this effect on neuron density and how it may differ between the different conditions falling under the realm of cardiovascular disease has yet to be studied. Analysis of this relationship between the Autonomic Nervous System (ANS) and cardiovascular function can provide insight into the disease process of each of the studied conditions, and more specifically, whether the ANS plays more of a causative or compensatory role in these instances. In this study, stellate ganglion pathology from patients with Coronary Artery Disease (CAD), Myocardial Infarction (MI), or Heart Failure (HF) were studied and compared to subjects with little to no cardiovascular pathology. We hypothesized that cardiovascular disease patients would have higher levels of neural remodeling, and perhaps more so in chronic conditions like CAD and HF as opposed to single events like MI. Stellate ganglia were harvested from one or both sides of 17 human cadavers and prepared slides from the middle section of each ganglion were scanned digitally for analysis. Neurons were counted using an automated algorithm accounting for size and shape to specifically select for nerve cell bodies, and for further analysis, heat maps of neuron nearest neighbor density were created. Analysis considering the variables of neuron size, number of neurons, and percent area of the ganglion occupied by neurons resulted in a statistical main effect of disease cohort but not side of the ganglion or the interaction of cohort and side. Between subject effects showed that only average neuron size was a significant factor in the model. Overall, patients with cardiovascular disease displayed neural remodeling in comparison to those with little to no cardiovascular pathology, and these effects were different across the several different conditions. Some caveats to this study were sample size, especially for MI patients, and analysis of only the middle section of each ganglion. A further analysis including more of the ganglion outside of a representative section, and more subjects in each cohort, especially with MI pathology, shows promise of more definitive conclusions.