de Micheli A, Medrano G A, García Moreira C
Arch Inst Cardiol Mex. 1983 Sep-Oct;53(5):387-96.
The paper describes the electrical changes in 115 mongrel dogs with exposed heart and open pericardium, during the gradual development of diastolic and combined (diastolic and systolic) overloading of the right ventricle. Ventricular overload was produced by means of a constant venous infusion of saline solution: up to 12 liters in 3 hours and half. In all cases, right intraventricular conduction disturbances, of either proximal or distal type, appeared. Right blocks were classified on the base of the topography of the ventricular activation delay. They were correlated with the hemodynamic adaptation. The results of this study allow us to formulate the following main points: 1) Disturbances of the right intraventricular conduction during experimental diastolic and combined overloading of the ipsilateral ventricle, seem to be due to a distention of the ventricular specialized fibers; 2) proximal right blocks are related to a global dilatation of the ventricular chamber, secondary either to a quick overloading or to a decrease in the myocardial capacity for adaptation; 3) distal right blocks are caused more frequently by a distention of the anterolateral portions of the free right ventricular wall, where the right middle subdivision is located.
本文描述了115只心脏暴露且心包开放的杂种犬在右心室舒张期和联合(舒张期和收缩期)超负荷逐渐发展过程中的电变化。通过持续静脉输注生理盐水造成心室超负荷:在3个半小时内输注多达12升。在所有病例中,均出现了近端或远端类型的右心室内传导障碍。根据心室激活延迟的部位对右束支传导阻滞进行分类。它们与血流动力学适应相关。本研究结果使我们能够总结出以下要点:1)在实验性同侧心室舒张期和联合超负荷期间,右心室内传导障碍似乎是由于心室特殊纤维的扩张所致;2)近端右束支传导阻滞与心室腔的整体扩张有关,这是快速超负荷或心肌适应能力下降的继发结果;3)远端右束支传导阻滞更常见于右心室游离壁前外侧部分的扩张,右中间分支位于该部位。