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颈动脉窦压力感受器刺激通过自主神经调节预防急性心肌梗死诱发的心律失常。

Carotid baroreceptor stimulation prevents arrhythmias induced by acute myocardial infarction through autonomic modulation.

作者信息

Liao Kai, Yu Lilei, He Bo, Huang Bing, Yang Kang, Saren Gaowa, Wang Songyun, Zhou Xiaoya, Jiang Hong

机构信息

Department of Cardiology, Renmin Hospital of Wuhan University and Cardiovascular Research Institute of Wuhan University, Wuhan, China.

出版信息

J Cardiovasc Pharmacol. 2014 Nov;64(5):431-7. doi: 10.1097/FJC.0000000000000135.

Abstract

: Electrical carotid baroreceptor stimulation (CBS) has shown therapeutic potential for resistant hypertension and heart failure by resetting autonomic nervous system, but the impacts on arrhythmias remains unclear. This study evaluated the effects of CBS on ventricular electrophysiological properties in normal dog heart and arrhythmias after acute myocardial infarction (AMI). In the acute protocol, anesthetized open chest dogs were exposed to 1 hour left anterior descending coronary occlusion as AMI model. Dogs were received either sham treatment (Control group, n = 8) or CBS (CBS group, n = 8), started 1 hour before AMI. CBS resulted in pronounced prolongation of ventricular effective refractory period and reduction of the maximum action potential duration restitution slope (from 0.85 ± 0.15 in the baseline state to 0.67 ± 0.09 at the end of 1 hour, P < 0.05) before AMI. Number of premature ventricular contractions (277 ± 168 in the Control group vs. 103 ± 84 in the CBS group, P < 0.05) and episodes of ventricular tachycardia/ventricular fibrillation (7 ± 3 in the Control group vs. 3 ± 2 in the CBS group, P < 0.05) was decreased compared with the control group during AMI. CBS buffered low-frequency/high-frequency ratio raise during AMI. Ischemic size was not affected by CBS. CBS may have a beneficial impact on ventricular arrhythmias induced by AMI through modulation of autonomic tone.

摘要

电刺激颈动脉压力感受器(CBS)已通过重置自主神经系统显示出对顽固性高血压和心力衰竭的治疗潜力,但对心律失常的影响仍不清楚。本研究评估了CBS对正常犬心脏心室电生理特性以及急性心肌梗死(AMI)后心律失常的影响。在急性实验方案中,将麻醉开胸犬暴露于左前降支冠状动脉闭塞1小时以建立AMI模型。犬只在AMI前1小时接受假治疗(对照组,n = 8)或CBS(CBS组,n = 8)。在AMI前,CBS导致心室有效不应期明显延长,最大动作电位时程恢复斜率降低(从基线状态的0.85±0.15降至1小时末的0.67±0.09,P < 0.05)。在AMI期间,与对照组相比,室性早搏数量(对照组为277±168,CBS组为103±84,P < 0.05)和室性心动过速/心室颤动发作次数(对照组为7±3,CBS组为3±2,P < 0.05)减少。CBS缓冲了AMI期间低频/高频比值的升高。缺血面积不受CBS影响。CBS可能通过调节自主神经张力对AMI诱发的室性心律失常产生有益影响。

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