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犬心冠状动脉闭塞后传出交感神经和迷走神经去神经支配的时间进程。

Time course of denervation of efferent sympathetic and vagal nerves after occlusion of the coronary artery in the canine heart.

作者信息

Inoue H, Zipes D P

机构信息

Krannert Institute of Cardiology, Indiana University School of Medicine, Indianapolis 46202.

出版信息

Circ Res. 1988 Jun;62(6):1111-20. doi: 10.1161/01.res.62.6.1111.

Abstract

To determine the time course of efferent sympathetic denervation after transmural myocardial infarction (TMI) and of efferent vagal denervation after transmural or nontransmural myocardial infarction (NTMI), we measured effective refractory periods (ERP) basal and apical to TMI or NTMI in secobarbital-anesthetized, open-chest dogs. In eight dogs with latex-induced TMI, bilateral ansae subclaviae stimulation shortened ERP at all 45 apical and basal test sites before latex injection. After latex injection, ERP shortening was unchanged at all 15 basal sites but was eliminated (less than or equal to 2 msec shortening) at three apical sites in 5-20 minutes and at 14 of 30 apical sites 30-180 minutes after latex injection. At the remaining 13 apical sites, ERP shortening was not eliminated but attenuated significantly in 5-180 minutes. ERP shortening induced by infused norepinephrine (0.20-0.25 microgram/kg/min) did not differ between basal and apical test sites 3-4 hours after latex injection; that is, no supersensitivity occurred. Of six dogs with TMI produced by ligation of multiple coronary arteries without latex injection, ERP shortening induced by efferent sympathetic neural stimulation was eliminated at 10 apical sites in four dogs over a period of 3 hours. At 14 apical sites that did not show denervation in these six dogs, ERP shortening was unchanged. In seven dogs with latex-induced TMI, bilateral vagal stimulation lengthened ERP at all 40 apical and basal test sites before latex injection. Vagally induced ERP lengthening was unchanged at all 13 basal sites after latex injection. ERP lengthening was eliminated (less than or equal to 1 msec lengthening) at four of 27 apical sites in 5-20 minutes and at 13 apical sites 30-180 minutes after latex injection. At the remaining 10 apical sites, ERP lengthening was not eliminated but decreased significantly 3 hours after latex injection. Of nine dogs with ligation-induced NTMI, five dogs showed elimination of vagally induced ERP lengthening at eight apical sites in 3 hours after ligation. ERP lengthening induced by vagal stimulation was unchanged at all 17 basal sites in nine dogs with NTMI. We conclude that TMI produced by latex injection and ligation of multiple coronary arteries produces heterogeneous loss of efferent sympathetic innervation in noninfarcted apical sites as early as 5-20 minutes after coronary occlusion with more complete denervation occurring over time.(ABSTRACT TRUNCATED AT 400 WORDS)

摘要

为了确定透壁性心肌梗死(TMI)后传出性交感神经去神经支配的时间进程以及透壁性或非透壁性心肌梗死(NTMI)后传出性迷走神经去神经支配的时间进程,我们在戊巴比妥麻醉、开胸的犬中测量了TMI或NTMI基底部和心尖部的有效不应期(ERP)。在8只因注射乳胶导致TMI的犬中,双侧锁骨下襻刺激在注射乳胶前使所有45个心尖部和基底部测试部位的ERP缩短。注射乳胶后,所有15个基底部部位的ERP缩短情况未变,但在注射乳胶后5 - 20分钟,3个心尖部部位的ERP缩短消失(缩短≤2毫秒),30 - 180分钟后,30个心尖部部位中的14个出现这种情况。在其余13个心尖部部位,ERP缩短未消失,但在5 - 180分钟内显著减弱。注射乳胶3 - 4小时后,输注去甲肾上腺素(0.20 - 0.25微克/千克/分钟)诱导的ERP缩短在基底部和心尖部测试部位之间没有差异;也就是说,未出现超敏反应。在6只通过结扎多条冠状动脉而未注射乳胶导致TMI的犬中,4只犬在3小时内,10个心尖部部位传出性交感神经刺激诱导的ERP缩短消失。在这6只犬中未显示去神经支配的14个心尖部部位,ERP缩短情况未变。在7只因注射乳胶导致TMI的犬中,双侧迷走神经刺激在注射乳胶前使所有40个心尖部和基底部测试部位的ERP延长。注射乳胶后,所有13个基底部部位迷走神经诱导的ERP延长情况未变。注射乳胶后5 - 20分钟,27个心尖部部位中的4个以及30 - 180分钟后13个心尖部部位的ERP延长消失(延长≤1毫秒)。在其余10个心尖部部位,ERP延长未消失,但注射乳胶3小时后显著降低。在9只因结扎导致NTMI的犬中,5只犬在结扎后3小时,8个心尖部部位迷走神经诱导的ERP延长消失。在9只患有NTMI的犬中,所有17个基底部部位迷走神经刺激诱导的ERP延长情况未变。我们得出结论,注射乳胶和结扎多条冠状动脉导致的TMI在冠状动脉闭塞后5 - 20分钟内,在未梗死的心尖部部位产生异质性的传出性交感神经支配丧失,随着时间推移去神经支配更完全。(摘要截断于400字)

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