Cardiovascular Research Institute, Ioannina and Athens, Greece.
Cardiovascular Research Institute, Ioannina and Athens, Greece.
Life Sci. 2016 Jan 1;144:170-7. doi: 10.1016/j.lfs.2015.12.019. Epub 2015 Dec 8.
Sympathetic activation during myocardial ischemia enhances arrhythmogenesis, but the underlying pathophysiologic mechanisms remain unclear. We investigated the central sympathetic effects on ventricular repolarization during the early-period post-coronary artery occlusion.
We studied 12 Wistar rats (254±2 g) for 30 min following left coronary artery ligation, with (n=6) or without (n=6) pretreatment with the central sympatholytic agent clonidine. Mapping of left and right ventricular epicardial electrograms was performed with a 32-electrode array. As an index of sympathetic activation, heart rate variability in the frequency domain was calculated. Heart rate and repolarization duration were measured with a custom-made recording and analysis software, followed by calculation of intra- and inter-ventricular dispersion of repolarization.
Heart rate and heart rate variability indicated lower sympathetic activation in clonidine-treated rats during ischemia. Repolarization duration in the left ventricle prolonged after clonidine at baseline, independently of heart rate, but no differences were present 30 min post-ligation. Dispersion of repolarization in the right ventricle remained stable during ischemia, whereas it increased in the left ventricle, equally in both groups. A similar trend was observed for inter-ventricular dispersion, without differences between groups.
In addition to intra-ventricular repolarization-dispersion, anterior-wall myocardial ischemia may also increase inter-ventricular repolarization-dispersion. Progressive central sympathetic activation occurs during myocardial ischemia, but it does not affect intra- or inter-ventricular dispersion of ventricular repolarization during the early phase. Further research is warranted on the potential effects during subsequent time-periods.
心肌缺血时交感神经激活增强心律失常发生机制,但潜在的病理生理机制尚不清楚。本研究旨在探讨冠状动脉闭塞后早期中枢交感神经对心室复极的影响。
结扎左冠状动脉后,我们对 12 只 Wistar 大鼠(254±2 g)进行了 30 分钟的研究,其中 6 只大鼠给予中枢交感神经抑制剂可乐定预处理,6 只大鼠未给予可乐定预处理。采用 32 电极阵列进行左、右心室心外膜电图标测。以频域心率变异性作为交感神经激活的指标。使用定制的记录和分析软件测量心率和复极时间,并计算复极离散度。
可乐定处理组大鼠在缺血期间心率和心率变异性提示交感神经激活较低。在基础状态下,可乐定使左心室复极时间延长,与心率无关,但在结扎后 30 分钟时无差异。右心室复极离散度在缺血过程中保持稳定,而左心室复极离散度增加,两组间无差异。室间复极离散度也呈现出类似的趋势,但两组间无差异。
除了室间复极离散度外,前壁心肌缺血也可能增加室间复极离散度。心肌缺血时会发生进展性中枢交感神经激活,但这并不影响早期室性复极的室间和室内离散度。需要进一步研究后续时间窗的潜在影响。