Krannert Institute of Cardiology and Division of Cardiology, Department of Medicine, Indiana University School of Medicine Indianapolis, IN 46202-1228, USA.
Heart Rhythm. 2013 Apr;10(4):585-91. doi: 10.1016/j.hrthm.2012.12.015. Epub 2012 Dec 11.
Cervical vagal nerve (CVN) stimulation may improve left ventricular ejection fraction in patients with heart failure.
To test the hypothesis that sympathetic structures are present in the CVN and to describe the location and quantitate these sympathetic components of the CVN.
We performed immunohistochemical studies of the CVN from 11 normal dogs and simultaneously recorded stellate ganglion nerve activity, left thoracic vagal nerve activity, and subcutaneous electrocardiogram in 2 additional dogs.
A total of 28 individual nerve bundles were present in the CVNs of the first 11 dogs, with an average of 1.87±1.06 per dog. All CVNs contain tyrosine hydroxylase-positive (sympathetic) nerves, with a total cross-sectional area of 0.97±0.38 mm(2). The sympathetic nerves were nonmyelinated, typically located at the periphery of the nerve bundles and occupied 0.03%-2.80% of the CVN cross-sectional area. Cholineacetyltransferase-positive nerve fibers occupied 12.90%-42.86% of the CVN cross-sectional areas. Ten of 11 CVNs showed tyrosine hydroxylase and cholineacetyltransferase colocalization. In 2 dogs with nerve recordings, we documented heart rate acceleration during spontaneous vagal nerve activity in the absence of stellate ganglion nerve activity.
Sympathetic nerve fibers are invariably present in the CVNs of normal dogs and occupy in average up to 2.8% of the cross-sectional area. Because sympathetic nerve fibers are present in the periphery of the CVNs, they may be susceptible to activation by electrical stimulation. Spontaneous activation of the sympathetic component of the vagal nerve may accelerate the heart rate.
颈迷走神经(CVN)刺激可能改善心力衰竭患者的左心室射血分数。
检验 CVN 中存在交感神经结构的假说,并描述 CVN 中这些交感成分的位置和定量。
我们对 11 只正常犬的 CVN 进行了免疫组织化学研究,并在另外 2 只犬中同时记录了星状神经节神经活动、左胸迷走神经活动和皮下心电图。
前 11 只犬的 CVN 中共有 28 个单独的神经束,平均每只犬 1.87±1.06 个。所有 CVN 均含有酪氨酸羟化酶阳性(交感)神经,总横截面积为 0.97±0.38mm2。交感神经无髓鞘,通常位于神经束的外围,占 CVN 横截面积的 0.03%-2.80%。胆碱乙酰转移酶阳性神经纤维占 CVN 横截面积的 12.90%-42.86%。11 个 CVN 中有 10 个显示酪氨酸羟化酶和胆碱乙酰转移酶共定位。在 2 只具有神经记录的犬中,我们记录到在没有星状神经节神经活动的情况下,自主迷走神经活动期间心率加速。
交感神经纤维在正常犬的 CVN 中始终存在,平均占横截面积的 2.8%。由于交感神经纤维位于 CVN 的外围,它们可能容易受到电刺激的激活。迷走神经交感成分的自发激活可能会加速心率。