Motomura S, Iijima T, Taira N, Hashimoto K
Circ Res. 1975 Aug;37(2):146-55. doi: 10.1161/01.res.37.2.146.
The effects of neurotransmitters injected into the posterior and the anterior septal artery on the automaticity of the atrioventricular (AV) junctional area were examined in the excised, blood-perfused canine AV node preparation. An AV rhythm of 57.4 +/- 2.8 beats/min (N = 28) developed after the destruction of the sinoatrial node. l-Norepinephrine injected into the anterior septal artery increased the frequency of AV rhythm, but l-norepinephrine injected into the posterior septal artery caused a pacemaker shift from the anterior septal artery area to the posterior septal artery area. Acetylcholine injected into the posterior septal artery blocked retrograde conduction but did not decrease the frequency of AV rhythm; however, acetylcholine injected into the anterior septal artery decreased AV rhythm but did not affect retrograde conduction. Destruction of the posterior septal artery area failed to change AV rhythm. The surgically separated anterior septal artery preparation had the same rate as did the AV node preparation. The posterior septal artery preparation had a definitely lower rate and responded to smaller doses of l-norepinephrine than did the AV node preparation. The results of the present study indicate that AV rhythm in the AV node originates in the area supplied by the anterior septal artery and that the area supplied by the posterior septal artery, which has extremely low automaticity, is highly responsive to l-norepinephrine, resulting in nodal tachycardia.
在离体、血液灌注的犬房室结标本中,研究了向后间隔动脉和前间隔动脉注射神经递质对房室交界区自律性的影响。破坏窦房结后,出现了57.4±2.8次/分钟(N=28)的房室节律。向前间隔动脉注射左旋去甲肾上腺素可增加房室节律的频率,但向后间隔动脉注射左旋去甲肾上腺素会使起搏点从前间隔动脉区域转移至后间隔动脉区域。向后间隔动脉注射乙酰胆碱可阻断逆向传导,但不降低房室节律的频率;然而,向前间隔动脉注射乙酰胆碱会降低房室节律,但不影响逆向传导。破坏后间隔动脉区域未能改变房室节律。手术分离的前间隔动脉标本的速率与房室结标本相同。后间隔动脉标本的速率明显较低,对较小剂量的左旋去甲肾上腺素的反应比房室结标本更敏感。本研究结果表明,房室结中的房室节律起源于前间隔动脉供血区域,而后间隔动脉供血区域的自律性极低,对左旋去甲肾上腺素高度敏感,可导致结性心动过速。