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急性缺血对犬心室肌各向异性传导的影响。

Effects of acute ischemia on anisotropic conduction in canine ventricular muscle.

作者信息

Mizumaki K, Fujiki A, Tani M, Misaki T

机构信息

Second Department of Internal Medicine, Toyama Medical & Pharmaceutical University, Japan.

出版信息

Pacing Clin Electrophysiol. 1993 Aug;16(8):1656-63. doi: 10.1111/j.1540-8159.1993.tb01036.x.

Abstract

The effects of acute ischemia on conduction velocities in the longitudinal (theta L) and transverse (theta T) fiber axis were determined from epicardial activation patterns, recorded with 48 bipolar electrodes (plaque electrode, 25 x 35 mm) on the left anterior ventricular wall of eight dogs and the posterior wall of seven dogs. During left ventricular stimulation (cycle length = 300 msec) in the center of the plaque electrode, theta L, theta T, and the ratio of longitudinal to transverse conduction velocities (theta L/T) were measured before and 2 to 5 minutes after occlusion of the left anterior descending coronary artery or the left circumflex coronary artery. During the control state theta L was greater than theta T demonstrating anisotropic properties of cardiac muscle, not only in the anterior but also in the posterior wall. During acute ischemia theta L and theta T were decreased from the control value and theta T was decreased by a greater extent than theta L resulting in an increase in theta L/T from 1.83 +/- 0.31 (mean +/- SD) to 2.19 +/- 0.36 in the anterior wall and from 1.58 +/- 0.17 to 1.92 +/- 0.28 in the posterior wall. During ventricular fibrillation some lines of conduction block were parallel to the long axis of epicardial muscle fiber bundle and the others were perpendicular. In conclusion, acute ischemia increased anisotropic conduction (theta L/T) in the epicardial ventricular muscle mainly due to greater reduction in theta T, in the anterior and the posterior wall. This augmented anisotropic ventricular conduction may have some relation to the initiation of ventricular fibrillation during acute ischemia.

摘要

通过在8只犬的左前心室壁和7只犬的后壁上使用48个双极电极(斑块电极,25×35mm)记录的心外膜激活模式,确定急性缺血对纵向(θL)和横向(θT)纤维轴传导速度的影响。在斑块电极中心进行左心室刺激(周期长度=300毫秒)期间,在闭塞左前降支冠状动脉或左旋支冠状动脉之前以及闭塞后2至5分钟测量θL、θT以及纵向与横向传导速度之比(θL/T)。在对照状态下,θL大于θT,这表明心肌不仅在前壁而且在后壁均具有各向异性特性。在急性缺血期间,θL和θT均从对照值下降,并且θT的下降幅度大于θL,导致前壁的θL/T从1.83±0.31(平均值±标准差)增加到2.19±0.36,后壁的θL/T从1.58±0.17增加到1.92±0.28。在心室颤动期间,一些传导阻滞线与心外膜肌纤维束的长轴平行,而其他传导阻滞线则与之垂直。总之,急性缺血主要由于θT在前壁和后壁的更大程度降低而增加了心外膜心室肌的各向异性传导(θL/T)。这种增强的心室各向异性传导可能与急性缺血期间心室颤动的发生有关。

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