Perez-Lugones Alejandro, McMahon James T, Ratliff Norman B, Saliba Walid I, Schweikert Robert A, Marrouche Nassir F, Saad Eduardo B, Navia José L, McCarthy Patrick M, Tchou Patrick, Gillinov A Marc, Natale Andrea
Department of Cardiology, Center for Atrial Fibrillation, The Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
J Cardiovasc Electrophysiol. 2003 Aug;14(8):803-9. doi: 10.1046/j.1540-8167.2003.03075.x.
Specialized Conducting Cells in Human PV.
Depolarizations similar to those from the sinus node have been documented from the pulmonary veins after isolation procedures. We assessed the hypothesis that sinus node-like tissue is present in the pulmonary veins of humans.
Pulmonary vein tissue was obtained from five autopsies (four individuals with a history of atrial fibrillation and one without a history of atrial arrhythmias) and five transplant heart donors. Autopsy veins were fixed in formaldehyde and processed for light microscopy to identify areas having possible conductive-like tissue. Areas requiring additional study were extracted from paraffin blocks and reprocessed for electron microscopy. Donor specimens were fixed in formaldehyde for histologic sections and glutaraldehyde for electron microscopy. Myocardial cells with pale cytoplasm were identified by light microscopy in 4 of the 5 autopsy subjects. Electron microscopy confirmed the presence of P cells, transitional cells, and Purkinje cells in the pulmonary veins of these cases.
Our report is the first to show the presence of P cells, transitional cells, and Purkinje cells in human pulmonary veins. Whether these cells are relevant in the genesis of atrial fibrillation requires further study.
人类肺静脉中的特殊传导细胞。
在隔离手术后,已记录到肺静脉中存在与窦房结相似的去极化现象。我们评估了人类肺静脉中存在窦房结样组织这一假说。
从5例尸检(4例有房颤病史,1例无心律失常病史)和5例心脏移植供体获取肺静脉组织。尸检的肺静脉用甲醛固定,进行光学显微镜检查以识别可能存在传导样组织的区域。需要进一步研究的区域从石蜡块中取出,重新处理用于电子显微镜检查。供体标本用甲醛固定用于组织学切片,用戊二醛固定用于电子显微镜检查。5例尸检对象中有4例通过光学显微镜鉴定出细胞质淡染的心肌细胞。电子显微镜证实这些病例的肺静脉中存在P细胞、移行细胞和浦肯野细胞。
我们的报告首次表明人类肺静脉中存在P细胞、移行细胞和浦肯野细胞。这些细胞是否与房颤的发生有关需要进一步研究。