Sympathetic Nervous System Analysis for Coronary Artery Dissection

Overseen By Pamela Engrav

Age: 18+

Sex: Female

Trial Phase: Academic

Sponsor: Mayo Clinic

Must not be taking: Anticoagulants, Antiplatelets

Disqualifiers: Pregnancy, Unstable cardiac, Prisoner, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: Unknown

50 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial explores differences in the body's "fight or flight" system (Sympathetic Nervous System) and artery health between individuals who have experienced spontaneous coronary artery dissection (SCAD) and those who have not. Participants in the SCAD group will undergo assessments of heart and blood vessel functions, while a control group of healthy individuals will do the same for comparison. Those with SCAD confirmed by specific heart scans are suitable for the SCAD group, while individuals without any heart disease are ideal candidates for the control group. As an unphased trial, this study provides participants the chance to contribute to important research that may enhance understanding and treatment of SCAD.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but you cannot participate if you are actively being treated with anticoagulation (blood thinners) or dual antiplatelet therapy (medications that prevent blood clots).

What prior data suggests that this analysis is safe for participants?

Research has shown that Sympathetic Nervous System Analysis is generally safe. This process mainly involves tests to assess the body's "fight or flight" system. No reports of harmful effects from these tests exist. Since the trial observes natural body functions rather than testing a new drug or device, the risk remains low. For those concerned about safety, similar studies have not shown negative outcomes, making this approach well-tolerated for participants. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it aims to explore the role of the sympathetic nervous system in coronary artery dissection, a condition with limited understanding and treatment options. Unlike traditional treatments that focus on managing symptoms and preventing complications, this trial seeks to uncover new insights into neurovascular function, which could lead to innovative approaches for early detection or prevention. By comparing the neurovascular function of individuals with a history of spontaneous coronary artery dissection (SCAD) to healthy controls, the trial may reveal key differences that could inform future therapeutic strategies.

What evidence suggests that this analysis is effective for assessing sympathetic function in coronary artery dissection?

Research has shown that the body's "fight or flight" system, known as the sympathetic nervous system, might link to spontaneous coronary artery dissection (SCAD). SCAD involves a tear in the heart's artery wall. This trial will compare the sympathetic nervous system and artery health between participants in the SCAD group and those in the Healthy Control Group. The aim is to understand how the nervous system might impact artery health. This research could lead to better prevention or treatment methods for SCAD. However, more data is needed to confirm the effectiveness of these approaches. ^{1 2 3 4 5}

Who Is on the Research Team?

Marysia Tweet, MD, MS

Principal Investigator

Mayo Clinic

Are You a Good Fit for This Trial?

This study is for individuals with a history of spontaneous coronary artery dissection (SCAD), confirmed by specific heart imaging tests, and healthy volunteers without any cardiac disease. Pregnant women, those with unstable heart conditions recently, or on certain blood thinners can't participate.

Inclusion Criteria

My SCAD diagnosis was confirmed through specific heart imaging tests.

I have never had heart disease.

Exclusion Criteria

I have not had any heart problems in the last month.

Pregnancy

I am currently on blood thinners or taking two types of medication to prevent blood clots.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Diagnostic Assessment

Participants undergo a series of diagnostic studies to assess neurovascular function

Baseline

Follow-up

Participants are monitored for safety and effectiveness after diagnostic assessments

4 weeks

What Are the Treatments Tested in This Trial?

Interventions

• Sympathetic Nervous System Analysis

Trial Overview The trial investigates the sympathetic nervous system's activity (our body's fight or flight response) and arterial health in SCAD patients compared to healthy people using non-invasive tests like echocardiograms and carotid ultrasounds.

How Is the Trial Designed?

Group I: Spontaneous coronary artery dissection (SCAD) group Experimental Treatment 6 Interventions

Subject with a history of SCAD will undergo a series of diagnostic studies to assess neurovascular function.

Group II: Healthy Control Group Experimental Treatment 6 Interventions

Healthy subjects will undergo a series of diagnostic studies to assess neurovascular function.

Who Is Running the Clinical Trial?

Mayo Clinic

Lead Sponsor

Trials

3,427

Recruited

3,221,000+

National Heart, Lung, and Blood Institute (NHLBI)

Collaborator

Trials

3,987

Recruited

47,860,000+

Published Research Related to This Trial

The axillary approach for cervico-dorsal sympathetic surgery provides excellent access to key sympathetic ganglions, allowing for complete sympathectomy in all cases studied.

Postoperative recovery was generally smooth, although some complications like transient Horner's Syndrome and pneumothorax occurred, suggesting that while the procedure is effective, careful technique is necessary to minimize risks.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Axillary sympathectomy for upper extremities. Man, B., Kraus, L., Motovic, A.[2019]

Anatomical variations of the sympathetic trunk at the T3 and T4 levels were observed in 44 patients undergoing surgery for palmar hyperhidrosis, with significant differences in the location of sympathetic ganglia and their pathways, which could impact surgical outcomes.

The study highlights the need for careful inspection of the sympathetic trunk's position, especially in cases of severe obesity, and suggests that a lateral extension of electrocoagulation may be necessary to ensure complete blockage of sympathetic nerve stimuli during surgery.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Topographical considerations under video-scope guidance in the T3,4 levels sympathetic surgery. Kim, DH., Hong, YJ., Hwang, JJ., et al.[2016]

The sympathetic nervous system plays a crucial role in regulating circulation and is significantly involved in cardiovascular diseases, affecting prognosis and treatment outcomes, particularly in heart failure.

Inhibition of angiotensin II synthesis through ACE-inhibitors can reduce sympathetic activation without increasing sympathetic activity, which is beneficial compared to other treatments like nitrates.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Sympathy and heartache: new information on the sympathetic nervous system]. Spieker, LE., Binggeli, C., Lüscher, TF., et al.[2007]

This study reviewed 15 human studies to detail the anatomical variations of the upper thoracic sympathetic trunk, highlighting that the cervicothoracic ganglion and nerve of Kuntz were present in 77% and 53% of cases, respectively.

Understanding these anatomical variations can enhance the effectiveness of upper thoracic sympathectomy procedures, suggesting that more standardized reporting in future studies is needed for better comparison and clinical outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Anatomical variations of the upper thoracic sympathetic chain: a review. Vanlommel, J., Van Look, L., Peetermans, M., et al.[2022]

This study identified the primary blood supply to the cervical sympathetic chain and ganglia in 12 human cadavers, highlighting key arteries such as the ascending pharyngeal and thyrocervical trunk, which is crucial for avoiding surgical complications.

A specific area in the neck was found to have a deficiency in blood supply, which could increase the risk of vascular insufficiency during cervical surgeries, emphasizing the importance of this knowledge for surgeons to prevent potential autonomic dysfunction.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Blood supply of the human cervical sympathetic chain and ganglia. Tubbs, RS., Salter, G., Wellons, JC., et al.[2019]

The lumbar sympathetic chains are located differently than in the thorax, which can complicate surgical procedures and affect the outcomes of lumbar sympathectomy, particularly due to anatomical variations.

Complications from lumbar sympathectomy can include inadequate denervation of the lower extremities, brief paralysis of the intestines, excessive sweating in unaffected areas, sexual dysfunction, and post-surgery nerve pain.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The lumbar sympathetic. Anatomy and surgical implications. Simeone, FA.[2005]

The study of 6 human fetuses revealed that the thoracic sympathetic trunk is organized into 12 segments, each connected to spinal nerves and giving off at least 4-5 peripheral nerves, indicating a more complex structure than previously thought.

The research identified three categories of nerves, including small nerves that form extensive plexuses in costovertebral joint capsules, suggesting that these nerves may play a significant role in somatosensory functions and should be considered during surgical procedures like sympathectomies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Branches of the thoracic sympathetic trunk in the human fetus. Groen, GJ., Baljet, B., Boekelaar, AB., et al.[2019]

Bilateral superior cervical sympathetic ganglion occlusion (SCG) significantly reduces the incidence and mortality of aortic dissection in rats, suggesting a protective effect against this condition.

The mechanism behind this protective effect may involve the inhibition of sympathetic activity and a decrease in the expression of collagen-1, Apelin, and matrix metalloproteinases (MMP-2 and MMP-9), which are associated with aortic wall integrity.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

[Effect of bilateral superior cervical sympathetic ganglion occlusion on pathological process of aortic dissection and its mechanism]. Zhang, Z., Wang, H., Zhang, Y., et al.[2023]

In a study involving 15 patients with vasospastic angina (VSA) and 15 control subjects, it was found that patients with VSA had significantly higher sympathetic nervous system (SNS) activity both at baseline and during mental stress, indicating a persistent increase in SNS activity.

The increased SNS activity in VSA patients was associated with significant hemodynamic changes, including elevated mean arterial blood pressure, suggesting that SNS plays a role in the pathogenesis of VSA by enhancing coronary vascular tone.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Direct evidence of sympathetic hyperactivity in patients with vasospastic angina. Boudou, N., Despas, F., Rothem, JV., et al.[2020]

The First International Symposium on Cardiac Sympathetic Neuroimaging highlighted its potential uses in diagnosing, prognosing, and monitoring treatments for autonomic and neurocardiologic disorders, showcasing the importance of this imaging technique.

Discussions at the Symposium focused on strategies to increase the availability of cardiac sympathetic neuroimaging in U.S. medical centers, indicating a push towards broader implementation of this diagnostic tool.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Cardiac sympathetic neuroimaging: summary of the First International Symposium. Goldstein, DS., Orimo, S.[2021]

Citations

1. clinicaltrials.gov clinicaltrials.gov/study/NCT05699200

A Study to Analyze the Role of Sympathetic Nervous ... The purpose of this research is to compare sympathetic function (flight or fight system) and arterial health including structure and mechanics of participants ...

2. clinicaltrial.be clinicaltrial.be/en/details/189653?per_page=20&recruiting=1&enrolling_by_invitation=1&active_not_recruiting=1&not_yet_recruiting=0&completed=0&only_recruiting=0&only_eligible=0

A Study to Analyze the Role of Sympathetic Nervous ... The purpose of this research is to compare sympathetic function (flight or fight system) and arterial health including structure and ...

3. withpower.com withpower.com/trial/phase-aneurysm-dissecting-1-2023-8425e

Sympathetic Nervous System Analysis for Coronary Artery ... This study is for individuals with a history of spontaneous coronary artery dissection (SCAD), confirmed by specific heart imaging tests, and healthy volunteers ...

4. acc.org acc.org/Latest-in-Cardiology/Articles/2025/08/01/01/Cover-Story-Hidden-in-Plain-Sight

Cover Story | Hidden in Plain Sight: SCAD as a Major ... Tweet has an NIH-funded K23 grant to investigate the autonomic nervous system's role in SCAD to improve prevention and treatment. Her research ...

5. mayo.edu mayo.edu/research/clinical-trials/cls-20542850

A Study To Analyze The Role Of Sympathetic Nervous ... The purpose of this research is to compare sympathetic function (flight or fight system), arterial structure and mechanics of participants with history of ...