Cardinal René, Pagé Pierre, Vermeulen Michel, Ardell Jeffrey L, Armour J Andrew
Centre de Recherche, Hôpital du Sacré-Coeur de Montréal, Canada.
Auton Neurosci. 2009 Jan 28;145(1-2):55-62. doi: 10.1016/j.autneu.2008.11.007. Epub 2008 Dec 13.
Ganglionated plexuses (GPs) are major constituents of the intrinsic cardiac nervous system, the final common integrator of regional cardiac control. We hypothesized that nicotinic stimulation of individual GPs exerts divergent regional influences, affecting atrial as well as ventricular functions. In 22 anesthetized canines, unipolar electrograms were recorded from 127 atrial and 127 ventricular epicardial loci during nicotine injection (100 mcg in 0.1 ml) into either the 1) right atrial (RA), 2) dorsal atrial, 3) left atrial, 4) inferior vena cava-inferior left atrial, 5) right ventricular, 6) ventral septal ventricular or 7) cranial medial ventricular (CMV) GP. In addition to sinus and AV nodal function, neural effects on atrial and ventricular repolarization were identified as changes in the area subtended by unipolar recordings under basal conditions and at maximum neurally-induced effects. Animals were studied with intact AV node or following ablation to achieve ventricular rate control. Atrial rate was affected in response to stimulation of all 7 GPs with an incidence of 50-95% of the animals among the different GPs. AV conduction was affected following stimulation of 6/7 GP with an incidence of 22-75% among GPs. Atrial and ventricular repolarization properties were affected by atrial as well as ventricular GP stimulation. Distinct regional patterns of repolarization changes were identified in response to stimulation of individual GPs. RAGP predominantly affected the RA and posterior right ventricular walls whereas CMVGP elicited biatrial and biventricular repolarization changes. Spatially divergent and overlapping cardiac regions are affected in response to nicotinic stimulation of neurons in individual GPs.
神经节丛(GPs)是心脏固有神经系统的主要组成部分,是区域心脏控制的最终共同整合器。我们假设对单个神经节丛进行烟碱刺激会产生不同的区域影响,从而影响心房和心室功能。在22只麻醉犬中,在向以下部位注射尼古丁(0.1 ml中含100 mcg)期间,从127个心房和127个心室心外膜位点记录单极电图:1)右心房(RA)、2)背侧心房、3)左心房、4)下腔静脉-左下心房、5)右心室、6)室间隔腹侧心室或7)颅内侧心室(CMV)神经节丛。除了窦房结和房室结功能外,对心房和心室复极的神经影响被确定为基础条件下和最大神经诱导效应下单极记录所覆盖区域的变化。在完整房室结或消融后对动物进行研究以实现心室率控制。刺激所有7个神经节丛均会影响心房率,不同神经节丛中受影响动物的发生率为50 - 95%。刺激7个神经节丛中的6个会影响房室传导,神经节丛中的发生率为22 - 75%。心房和心室复极特性受心房和心室神经节丛刺激的影响。对单个神经节丛刺激的反应中可识别出不同的复极变化区域模式。右心房神经节丛主要影响右心房和右心室后壁,而颅内侧心室神经节丛引起双心房和双心室复极变化。对单个神经节丛中的神经元进行烟碱刺激会影响心脏不同区域,这些区域在空间上既有差异又有重叠。