Wallick D W, Stuesse S L, Masuda Y
Circulation. 1986 Apr;73(4):830-6. doi: 10.1161/01.cir.73.4.830.
Concurrent stimulation of the parasympathetic and sympathetic branches of the autonomic nervous system causes a diminished sympathetic response at high levels of vagal activity. This "accentuated antagonism" has been demonstrated for cardiac chronotropic, inotropic, and dromotropic responses. The effect on conduction was demonstrated with tonic stimulation of the vagus nerve. However, normally the vagus nerve fires periodically at certain times in the cardiac cycle. Thus, we have studied whether a similar interaction exists in the modulation of atrioventricular condition when short bursts of vagal stimulation were placed in various portions of the cardiac cycle. Anesthetized open-chest mongrel dogs were instrumented for stimulation of the cervical vagi and stellate ganglia when the heart was paced. We determined the relationship between cardiac cycle length, direction of action potential propagation, and levels of sympathetic and vagal activation and their effects on atrioventricular conduction times. All of the factors investigated, namely levels of vagal and stellate stimulation, pacing intervals, and direction of propagation of action potentials, affected atrioventricular conduction times. Furthermore, the vagal effect was greater at short cardiac cycle lengths. When bursts of vagal stimulation were timed to result in maximal or minimal prolongation of atrioventricular conduction, no significant effects of sympathetic-parasympathetic interaction on atrioventricular conduction times were apparent. However, an analysis of the differences in prolongation of atrioventricular conduction with periodic vagal stimulation revealed that a significant sympathetic-vagal interaction existed for these differences. Thus, autonomic neurotransmitters differentially affect cardiac conduction times depending on time of application of the stimulus.
自主神经系统的副交感神经和交感神经分支同时受到刺激时,在高迷走神经活动水平下会导致交感反应减弱。这种“增强的拮抗作用”已在心脏变时性、变力性和变传导性反应中得到证实。通过迷走神经的强直刺激证明了对传导的影响。然而,正常情况下,迷走神经在心动周期的特定时间周期性放电。因此,我们研究了在心动周期的不同时段施加短串迷走神经刺激时,在房室传导调节中是否存在类似的相互作用。对开胸麻醉的杂种犬进行仪器植入,以便在心脏起搏时刺激颈迷走神经和星状神经节。我们确定了心动周期长度、动作电位传播方向以及交感神经和迷走神经激活水平之间的关系,以及它们对房室传导时间的影响。所有研究的因素,即迷走神经和星状神经节刺激水平、起搏间期以及动作电位传播方向,均影响房室传导时间。此外,在短心动周期长度时迷走神经的作用更大。当迷走神经刺激串的时间安排导致房室传导最大或最小延长时,交感 - 副交感神经相互作用对房室传导时间没有明显影响。然而,对周期性迷走神经刺激导致的房室传导延长差异进行分析发现,这些差异存在显著的交感 - 迷走神经相互作用。因此,自主神经递质根据刺激施加的时间不同而对心脏传导时间产生不同影响。