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单侧星状神经节刺激和切除对犬急性心肌缺血诱导的电生理变化的影响。

Effects of unilateral stellate ganglion stimulation and ablation on electrophysiologic changes induced by acute myocardial ischemia in dogs.

作者信息

Janse M J, Schwartz P J, Wilms-Schopman F, Peters R J, Durrer D

出版信息

Circulation. 1985 Sep;72(3):585-95. doi: 10.1161/01.cir.72.3.585.

Abstract

We recorded direct-current extracellular electrograms simultaneously from 60 left ventricular epicardial sites in 38 alpha-chloralose-anesthetized dogs during repeated, 5 min coronary arterial occlusions. In each dog recordings made during control occlusions were compared with those made in occlusions after, or during, the following interventions on the sympathetic nervous system: left stellate ganglion stimulation, left stellectomy, right stellectomy, and clamping the abdominal aorta with intact sympathetic nerves to induce a rise of blood pressure equal to that present during left stellate stimulation. Heart rate was kept constant. Measurements included determination of TQ segment potentials and times of local activation. After 2 min of ischemia, the degree of TQ segment depression was increased by left stellate ganglion stimulation and was decreased by both left stellectomy and clamping the aorta. Also, the area showing negative TQ potentials, indicating decreased resting membrane potentials, was enlarged by both left stellate stimulation and right stellectomy and reduced by left stellectomy. No differences were found in the results of experiments in which the left anterior descending coronary artery was occluded and those in which the circumflex branch was occluded. Left stellate stimulation significantly improved conduction within the ischemic zone. No evidence was found to suggest that the arrhythmogenic effects of left stellate stimulation and of right stellectomy, confirmed in the present study, resulted from an increased likelihood for reentry in the subepicardium of the ischemic zone.

摘要

在38只α-氯醛糖麻醉的犬中,于反复进行5分钟冠状动脉闭塞期间,我们同时从60个左心室心外膜部位记录了直流细胞外电图。在每只犬中,将对照闭塞期间的记录与在对交感神经系统进行以下干预之后或期间的闭塞记录进行比较:左星状神经节刺激、左星状神经节切除术、右星状神经节切除术以及在交感神经完整的情况下夹闭腹主动脉以诱导血压升高至与左星状神经节刺激时相同的水平。心率保持恒定。测量包括TQ段电位和局部激活时间的测定。缺血2分钟后,左星状神经节刺激使TQ段压低程度增加,而左星状神经节切除术和夹闭主动脉均使其降低。此外,显示TQ负电位(表明静息膜电位降低)的区域在左星状神经节刺激和右星状神经节切除术后均增大,而在左星状神经节切除术后减小。在左前降支冠状动脉闭塞的实验结果与回旋支闭塞的实验结果之间未发现差异。左星状神经节刺激显著改善了缺血区内的传导。未发现证据表明本研究中证实的左星状神经节刺激和右星状神经节切除术的致心律失常作用是由于缺血区心外膜下折返可能性增加所致。

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