Abildskov J A
Eur Heart J. 1985 Nov;6 Suppl D:31-9. doi: 10.1093/eurheartj/6.suppl_d.31.
Neural mechanisms have important influences on ventricular repolarization. The normal gradients of repolarization such as that from long to short duration on the endocardial-epicardial axis are probably not the result of nonuniform neural effects. The ventricular distributions of individual cardiac sympathetic nerves is, however, localized and provides a possible basis for nonuniform effects on repolarization in various disease states. Such localized sympathetic effects are the probable mechanism of electrocardiographic waveform abnormalities associated with neurologic disease and a possible mechanism of the idiopathic prolonged QT interval syndromes. The medical significance of nonuniform neural influences on ventricular repolarization includes the evaluation of neurogenic electrocardiographic waveform abnormalities that may be erroneously attributed to intrinsic heart disease. Of greater importance, nonuniform repolarization has established relations to cardiac arrhythmias including ventricular fibrillation and nonuniform sympathetic effects on repolarization may be a significant factor in the occurrence and persistence of these disorders. Parasympathetic influences on ventricular repolarization are slight compared to sympathetic effects and may operate by opposing adrenergic effects.
神经机制对心室复极有重要影响。正常的复极梯度，如心内膜 - 心外膜轴上从长时程到短时程的梯度，可能并非神经效应不均一的结果。然而，单个心脏交感神经的心室分布是局部性的，这为各种疾病状态下复极的不均一效应提供了可能的基础。这种局部交感效应可能是与神经系统疾病相关的心电图波形异常的机制，也是特发性长QT间期综合征的一种可能机制。神经对心室复极的不均一影响的医学意义包括评估可能被错误归因于内在心脏病的神经源性心电图波形异常。更重要的是，复极不均一与包括心室颤动在内的心律失常已确立了关联，复极的交感效应不均一可能是这些疾病发生和持续存在的一个重要因素。与交感效应相比，副交感神经对心室复极的影响较小，可能通过对抗肾上腺素能效应起作用。
