Pagé P L, Dandan N, Savard P, Nadeau R, Armour J A, Cardinal R
Centre de Recherche de l'Hôpital du Sacré-Coeur de Montréal, Quebec, Canada.
J Thorac Cardiovasc Surg. 1995 Feb;109(2):377-88. doi: 10.1016/S0022-5223(95)70400-0.
Autonomic nerves and intrinsic cardiac neural elements are known to influence the electrophysiologic and dynamic properties of the heart. This study describes the regional distribution in the canine atria of electrophysiologic effects induced by stimulation of the right and left cervical vagosympathetic complexes, the right atrial ganglionated plexus, and the right and left stellate ganglia. Local atrial effects were determined from changes in QRST area of unipolar electrograms recorded from multiple sites with plaque electrodes sewn onto the atria in 16 anesthetized dogs.
(1) Although being very consistent in any given preparation, atrial changes varied between animals when similar neural structures were stimulated. (2) Among the common features identified between preparations, consistent effects were induced by neural stimulation in the region of the sinus node, indicating that this atrial region is the most richly innervated. (3) All other regions of the atria could be affected by stimulation of either right-sided or left-sided efferent nerves. (4) Responses to right atrial ganglionated plexus stimulation after atropine administration indicated that the corresponding fat pad contains both sympathetic and parasympathetic neural elements.
This study demonstrates that there is considerable overlapping of atrial innervation affecting all regions of the atria, as well as the sinus node region.
已知自主神经和心脏内在神经成分会影响心脏的电生理和动力学特性。本研究描述了刺激右、左颈迷走交感神经复合体、右心房神经节丛以及右、左星状神经节在犬心房中诱导的电生理效应的区域分布。通过将斑块电极缝在16只麻醉犬的心房上,从多个部位记录的单极心电图的QRST面积变化来确定局部心房效应。
(1)尽管在任何给定的制备中非常一致,但当刺激相似的神经结构时,不同动物之间的心房变化有所不同。(2)在不同制备之间确定的共同特征中,窦房结区域的神经刺激可诱导一致的效应,表明该心房区域的神经支配最为丰富。(3)心房的所有其他区域都可能受到右侧或左侧传出神经刺激的影响。(4)阿托品给药后对右心房神经节丛刺激的反应表明,相应的脂肪垫同时含有交感和副交感神经成分。
本研究表明,影响心房所有区域以及窦房结区域的心房神经支配存在相当大的重叠。