Janes R D, Johnstone D E, Brandys J C, Armour J A
Can J Physiol Pharmacol. 1986 Jul;64(7):958-69. doi: 10.1139/y86-165.
To further elucidate the functional anatomy of canine cardiac innervation as well as to assess the feasibility of producing regional left ventricular sympathetic denervation, the chronotropic and (or) regional left ventricular inotropic responses produced by stellate or middle cervical ganglion stimulation were investigated in 22 dogs before and after sectioning of individual major cardiopulmonary or cardiac nerves. Sectioning the right or left subclavian ansae abolished all cardiac responses produced by ipsilateral stellate ganglion stimulation. Sectioning a major sympathetic cardiopulmonary nerve, other than the right interganglionic nerve, usually reduced, but seldom abolished, regional inotropic responses elicited by ipsilateral middle cervical ganglion stimulation. Sectioning the dorsal mediastinal cardiac nerves consistently abolished the left ventricular inotropic responses elicited by right middle cervical ganglion stimulation but minimally affected those elicited by left middle cervical ganglion stimulation. In contrast, cutting the left lateral cardiac nerve decreased the inotropic responses in lateral and posterior left ventricular segments elicited by left middle cervical ganglion stimulation but had little effect on the inotropic responses produced by right middle cervical ganglion stimulation. In addition, the ventral mediastinal cardiac nerve was found to be a significant sympathetic efferent pathway from the left-sided ganglia to the left ventricle. These results indicate that the stellate ganglia project axons to the heart via the subclavian ansae and thus effective sympathetic decentralization can be produced by cutting the subclavian ansae; the right-sided cardiac sympathetic efferent innervation of the left ventricle converges intrapericardially in the dorsal mediastinal cardiac nerves; and the left-sided cardiac sympathetic efferent innervation of the left ventricle diverges to innervate the left ventricle by a number of nerves including the dorsal mediastinal, ventral mediastinal, and left lateral cardiac nerves. Thus consistent denervation of a region of the left ventricle can not be accomplished by sectioning an individual cardiopulmonary or cardiac nerve because of the functional and anatomical variability of the neural components in each nerve, as well as the fact that overlapping regions of the left ventricle are innervated by these different nerves.
为进一步阐明犬心脏神经支配的功能解剖结构，并评估产生局部左心室交感神经去神经支配的可行性，在切断个体主要心肺或心脏神经之前和之后，对22只犬进行了星状神经节或颈中神经节刺激所产生的变时性和（或）局部左心室变力性反应的研究。切断右侧或左侧锁骨下袢可消除同侧星状神经节刺激所产生的所有心脏反应。切断除右神经节间神经以外的主要交感心肺神经，通常会降低但很少消除同侧颈中神经节刺激所引起的局部变力性反应。切断纵隔后心脏神经始终会消除右颈中神经节刺激所引起的左心室变力性反应，但对左颈中神经节刺激所引起的反应影响极小。相比之下，切断左侧心脏外侧神经会降低左颈中神经节刺激所引起的左心室外侧和后段的变力性反应，但对右颈中神经节刺激所产生的变力性反应影响不大。此外，发现纵隔前心脏神经是从左侧神经节到左心室的重要交感传出通路。这些结果表明，星状神经节通过锁骨下袢将轴突投射到心脏，因此切断锁骨下袢可产生有效的交感神经去集中化；左心室的右侧心脏交感传出神经支配在心包内汇聚于纵隔后心脏神经；左心室的左侧心脏交感传出神经支配通过包括纵隔后、纵隔前和左侧心脏外侧神经在内的多条神经分散开来以支配左心室。因此，由于每条神经中神经成分的功能和解剖变异性，以及左心室的重叠区域由这些不同神经支配这一事实，切断一条单独的心肺或心脏神经无法实现左心室区域的持续去神经支配。
