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易发生持续性室性心律失常的犬慢性梗死心肌的细胞电生理特征

Cellular electrophysiologic characteristics of chronically infarcted myocardium in dogs susceptible to sustained ventricular tachyarrhythmias.

作者信息

Spear J F, Michelson E L, Moore E N

出版信息

J Am Coll Cardiol. 1983 Apr;1(4):1099-110. doi: 10.1016/s0735-1097(83)80112-0.

DOI:10.1016/s0735-1097(83)80112-0
PMID:6833648
Abstract

Standard microelectrode techniques were used to record transmembrane potentials and determine conduction characteristics in regions of mottled infarcts of canine epicardium, 3 to 5 days or 8 to 15 days after left anterior descending coronary artery occlusion and reperfusion. At 3 to 5 days, resting potential, action potential amplitude, maximal rate of depolarization and action potential duration at 30% repolarization were significantly reduced in the infarcted region. Cells on the epicardial surface showed improvement in resting potential, action potential amplitude and rate of depolarization between 3 to 5 days and 8 to 15 days after infarction. In normal noninfarcted tissues, conduction velocity parallel to fiber orientation was 0.54 +/- 0.06 m/s (mean +/- standard deviation). Slow conduction in infarcted regions ranged from 0.015 to 0.2 m/s. Action potentials recorded from slowly conducting regions tended to include cells with more depressed amplitude and rate of depolarization than other cells in infarcted regions; they also had inappropriately depressed overshoot relative to their resting potential. Action potentials in slowly conducting areas where local conduction block occurred were associated with prepotentials and notches on their depolarization and repolarization phases. The prepotentials and notches appeared to be caused by electrotonic interactions resulting from microcircuitous conduction around or across inexcitable areas. These findings demonstrate that areas of slow conduction are heterogenously distributed in the mottled infarct and suggest that disruptions in cell to cell electrical continuity and decreased excitability may contribute to this slow conduction.

摘要

采用标准微电极技术记录犬心外膜斑点状梗死区域的跨膜电位,并在左前降支冠状动脉闭塞和再灌注后3至5天或8至15天测定其传导特性。在3至5天时,梗死区域的静息电位、动作电位幅度、最大去极化速率和30%复极化时的动作电位持续时间显著降低。梗死3至5天和8至15天后,心外膜表面细胞的静息电位、动作电位幅度和去极化速率有所改善。在正常未梗死组织中,平行于纤维方向的传导速度为0.54±0.06 m/s(平均值±标准差)。梗死区域的缓慢传导速度范围为0.015至0.2 m/s。从缓慢传导区域记录的动作电位往往包含比梗死区域其他细胞幅度和去极化速率更低的细胞;相对于其静息电位,它们的超射也异常降低。在发生局部传导阻滞的缓慢传导区域,动作电位与其去极化和复极化阶段的预电位和切迹有关。预电位和切迹似乎是由围绕或穿过不可兴奋区域的微电路传导引起的电紧张相互作用所致。这些发现表明,缓慢传导区域在斑点状梗死中呈异质性分布,并提示细胞间电连续性的破坏和兴奋性降低可能导致这种缓慢传导。

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