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系列 1-第 2 部分:房室传导轴的比较解剖学。

Miniseries 1-Part II: the comparative anatomy of the atrioventricular conduction axis.

机构信息

Department of Medical and Surgical Therapeutics, Veterinary Faculty, University of Extremadura, Cáceres, Spain.

Department of Genetics and Morphology, Brasilia's University, Campus Asa Norte, Brasilia, Brazil.

出版信息

Europace. 2022 Mar 2;24(3):443-454. doi: 10.1093/europace/euab291.

Abstract

AIMS

The arrangement of the conduction axis is markedly different in various mammalian species. Knowledge of such variation may serve to question the validity of using animals as prospective models for design of systems for clinical use.

METHODS AND RESULTS

We compared the arrangement of the atrioventricular conduction axis in human, murine, canine, porcine, and bovine hearts, examining serially sectioned datasets from 20 human, 16 murine, 3 porcine, 5 canine, and 1 bovine hearts. We also analysed computed tomographic datasets obtained from bovines and one human heart. Unlike the situation in the human heart, there is no formation of an atrioventricular fibrous membranous septum in the murine, canine, porcine, nor bovine hearts. Canine, porcine, and bovine hearts also lack an infero-septal recess, when defined as a fibrous plate supporting the buttress of the atrial septum. In these species, half of the non-coronary leaflet is directly opposed to the ventricular septal surface.

CONCLUSION

There is a long right-sided non-branching component of the axis, which skirts the attachment of the non-coronary sinus of the aortic root. In the bovine heart, moreover, the left bundle branch usually extends intramyocardially as a solitary tape before surfacing and ramifying on the left ventricular septal surface. The difference in the atrioventricular conduction axis between species may influence the anatomical substrates for atrioventricular re-entry tachycardia, as well as providing inferences for assessing the risks of transcatheter implantation of the aortic valve. Further studies are now needed to assess these possibilities.

摘要

目的

不同哺乳动物物种的房室传导轴排列明显不同。了解这种差异可能有助于质疑将动物作为临床应用系统设计的前瞻性模型的有效性。

方法和结果

我们比较了人心、鼠心、犬心、猪心和牛心中房室传导轴的排列,检查了 20 个人心、16 只鼠心、3 只猪心、5 只犬心和 1 只牛心的连续切片数据集。我们还分析了从牛和 1 个人心获得的计算机断层扫描数据集。与人心不同,鼠心、犬心、猪心和牛心中没有房室纤维膜间隔的形成。犬心、猪心和牛心也缺乏下隔隐窝,当定义为支撑房间隔的纤维板时。在这些物种中,瓣叶的一半直接与室间隔表面相对。

结论

存在一个长的右侧非分支轴部分,绕过主动脉根部无冠状窦的附着处。此外,在牛心中,左束支通常在左心室间隔表面出现和分支之前作为单独的带子在心内膜内延伸。物种间房室传导轴的差异可能影响房室折返性心动过速的解剖学基础,并为评估经导管主动脉瓣植入的风险提供推断。现在需要进一步的研究来评估这些可能性。

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