Fontaliran F, Fillette F, Nassif G, Lascault G, Aouate P, Grosgogeat Y
Laboratoire d'électrophysiologie de la Salpétrière, service de cardiologie, Paris.
Arch Mal Coeur Vaiss. 1988 Mar;81(3):345-51.
A combined electrophysiological and histopathological study was conducted on sheep myocardium fragments rich in easily identifiable conduction cells subjected to electric shocks of varying intensity. Tissue fragments were immersed in a thermostatically-controlled bath at 37 degrees C, perfused with a carbonated standard tyrode solution at the rate of 30 ml/min and stimulated at a constant bipolar 1 C/sec tension twice as high as the threshold of diastolic excitability. After measurement of reference values, electric shocks of 2 to 80 joules were delivered between two electrodes placed on both sides of the tissue fragment. The electrophysiological part of the study showed disorders of conduction which, depending on the energy delivered, were more or less complete and reversible. The histopathological part of the study showed that conduction tissue was extremely fragile, even to low-energy shocks. This fragility was in glaring contrast with the relatively modest damage suffered by myocytes. Liquefaction and/or coagulation of Purkinje's cells was also striking, as it extended over an area much wider than that subjected to the shock. Thus, with medium intensity shocks destroyed conduction bundles were seen to creep between myocytes that often were perfectly normal or showed rare hypercontraction bands. Some myocytes were in the process of degeneration or even eosinophilic necrosis, but except in case of violent shock these were more or less isolated elements in the vicinity of the stimulated area. The fragility of conduction tissue and its selective damage by low-intensity shocks may be explained partly by its low impedance which allows preferential passage of the electric current.(ABSTRACT TRUNCATED AT 250 WORDS)
对富含易于识别的传导细胞的绵羊心肌片段进行了电生理与组织病理学联合研究,这些片段接受不同强度的电击。将组织片段浸入37摄氏度的恒温浴中,以30毫升/分钟的速度用碳酸化标准台氏液灌注,并以比舒张期兴奋性阈值高两倍的恒定双极1C/秒张力进行刺激。在测量参考值后,在置于组织片段两侧的两个电极之间施加2至80焦耳的电击。该研究的电生理部分显示传导紊乱,根据施加的能量不同,紊乱程度或多或少完全且可逆。该研究的组织病理学部分表明,即使是低能量电击,传导组织也极其脆弱。这种脆弱性与心肌细胞所遭受的相对较小的损伤形成鲜明对比。浦肯野细胞的液化和/或凝固也很明显,因为其扩展的区域比遭受电击的区域宽得多。因此,在中等强度电击下,可以看到被破坏的传导束在通常完全正常或仅显示罕见的过度收缩带的心肌细胞之间蔓延。一些心肌细胞正处于变性甚至嗜酸性坏死过程中,但除了剧烈电击的情况外,这些细胞在受刺激区域附近或多或少是孤立的。传导组织的脆弱性及其被低强度电击的选择性损伤,部分原因可能是其低阻抗,这使得电流能够优先通过。(摘要截取自250字)