Molina Cristina E, Heijman Jordi, Dobrev Dobromir
Institute of Pharmacology, West German Heart and Vascular Center, Faculty of Medicine, University Duisburg-Essen, Essen, Germany.
Cardiovascular Research Institute Maastricht, Faculty of Health, Medicine, and Life Sciences, Maastricht University, Maastricht, The Netherlands.
Arrhythm Electrophysiol Rev. 2016 May;5(1):14-9. doi: 10.15420/aer.2016.8.2.
A wide range of ion channels, transporters, signaling pathways and tissue structure at a microscopic and macroscopic scale regulate the electrophysiological activity of the heart. Each region of the heart has optimised these properties based on its specific role during the cardiac cycle, leading to well-established differences in electrophysiology, Ca(2+) handling and tissue structure between atria and ventricles and between different layers of the ventricular wall. Similarly, the right ventricle (RV) and left ventricle (LV) have different embryological, structural, metabolic and electrophysiological features, but whether interventricular differences promote differential remodeling leading to arrhythmias is not well understood. In this article, we will summarise the available data on intrinsic differences between LV and RV electrophysiology and indicate how these differences affect cardiac function. Furthermore, we will discuss the differential remodeling of both chambers in pathological conditions and its potential impact on arrhythmogenesis.
从微观和宏观尺度来看,多种离子通道、转运体、信号通路以及组织结构共同调节心脏的电生理活动。心脏的每个区域都根据其在心动周期中的特定作用对这些特性进行了优化,从而导致心房与心室之间以及心室壁不同层之间在电生理学、Ca(2+) 处理和组织结构方面存在公认的差异。同样,右心室(RV)和左心室(LV)具有不同的胚胎学、结构、代谢和电生理特征,但心室间差异是否会促进导致心律失常的差异性重塑尚未得到充分了解。在本文中,我们将总结关于左心室和右心室电生理内在差异的现有数据,并指出这些差异如何影响心脏功能。此外,我们将讨论病理状态下两个腔室的差异性重塑及其对心律失常发生的潜在影响。