Division of Cardiology, Department of Medicine, Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis, Indiana, USA.
J Cardiovasc Electrophysiol. 2012 Apr;23(4):404-12. doi: 10.1111/j.1540-8167.2011.02204.x. Epub 2011 Oct 28.
We tested the hypothesis that heart failure (HF) results in right atrial ganglionated plexus (RAGP) denervation that contributes to sinoatrial node dysfunction.
HF is associated with sinoatrial node dysfunction. However, the detailed mechanisms remain unclear.
We recorded nerve activity (NA) from the RAGP, right stellate ganglion (SG), and right vagal nerve in 7 ambulatory dogs at baseline and after pacing-induced HF. We also determined the effects of RAGP stimulation in isolated normal and HF canine RA.
NAs in both the SG and vagal were significantly higher in HF than at baseline. The relationship between 1-minute integrated NAs of vagal and RAGP showed either a positive linear correlation (Group 1, n = 4) or an L-shaped correlation (Group 2, n = 3). In all dogs, a reduced heart rate was observed when vagal-NA was associated with simultaneously increased RAGP-NA. On the other hand, when vagal-NA was not associated with increased RAGP-NA, the heart rate was not reduced. The induction of HF significantly decreased RAGP-NA in all dogs (P < 0.05). Stimulating the superior RAGP in isolated RA significantly reduced the sinus rate in normal but not the HF hearts. Immunohistochemical staining revealed lower densities of tyrosine hydroxylase- and choline acetyltransferase-positive nerve tissues in HF RAGP than normal (P < 0.001 and P = 0.001, respectively).
The RAGP-NA is essential for the vagal nerve to counterbalance the SG in sinus rate control. In HF, RAGP denervation and decreased RAGP-NA contribute to the sinus node dysfunction.
我们检验了这样一个假设，即心力衰竭（HF）导致右房神经节丛（RAGP）去神经支配，从而导致窦房结功能障碍。
HF 与窦房结功能障碍有关。然而，详细的机制仍不清楚。
我们在 7 只活动的狗中记录了 RAGP、右星状神经节（SG）和右迷走神经的神经活动（NA），分别在基线和起搏诱导 HF 后进行记录。我们还确定了 RAGP 刺激在分离的正常和 HF 犬右房中的作用。
HF 时 SG 和迷走神经的 NA 均明显高于基线。迷走神经和 RAGP 的 1 分钟积分 NA 之间的关系呈正线性相关（组 1，n = 4）或 L 形相关（组 2，n = 3）。在所有狗中，当迷走神经 NA 与同时增加的 RAGP-NA 相关时，心率降低。另一方面，当迷走神经 NA 与增加的 RAGP-NA 不相关时，心率不会降低。HF 的诱导显著降低了所有狗的 RAGP-NA（P < 0.05）。在分离的 RA 中刺激上 RAGP 显著降低了正常但不降低 HF 心脏的窦性心率。免疫组织化学染色显示 HF RAGP 中的酪氨酸羟化酶和胆碱乙酰转移酶阳性神经组织密度低于正常（P < 0.001 和 P = 0.001）。
RAGP-NA 对于迷走神经在窦率控制中与 SG 平衡至关重要。在 HF 中，RAGP 去神经支配和 RAGP-NA 减少导致窦房结功能障碍。
