Somberg J C
J Clin Pharmacol. 1985 Oct;25(7):529-39. doi: 10.1177/009127008502500709.
Studies of digitalis have revealed an appreciable role of the autonomic nervous system in the modulation of the cardiovascular toxicity of digitalis. Neuraxis transection experiments and studies using digitalis compounds that fail to enter the central nervous system suggest that centers located in the floor of the fourth cerebral ventricle play a substantial part in the neural arrhythmogenic effects of the digitalis glycosides. Electrical stimulation of the area postrema in partially digitalized animals, not otherwise manifesting ventricular arrhythmias, elicits ventricular tachycardia. Neuraxis transection experiments and studies with a charged digitalis derivative also suggest localization of the coronary vasoconstrictive properties of digitalis to the area postrema. The results suggest that this region of the brainstem is sensitive to a neurally active substance, digitalis, causing peripheral sympathetic effects of considerable consequence.
洋地黄的研究揭示了自主神经系统在调节洋地黄心血管毒性方面的重要作用。神经轴横断实验以及使用无法进入中枢神经系统的洋地黄化合物进行的研究表明，位于第四脑室底部的中枢在洋地黄苷的神经致心律失常作用中起重要作用。在部分洋地黄化的动物中，对原本未表现出室性心律失常的最后区进行电刺激，可诱发室性心动过速。神经轴横断实验以及使用带电荷的洋地黄衍生物进行的研究也表明，洋地黄的冠状动脉收缩特性定位于最后区。结果表明，脑干的这个区域对神经活性物质洋地黄敏感，会引起具有相当后果的外周交感效应。
