Skinner J E, Wolf S G, Kresh J Y, Izrailtyan I, Armour J A, Huang M H
Totts Gap Institute, Bangor PA 18013, USA.
Integr Physiol Behav Sci. 1996 Apr-Jun;31(2):122-46. doi: 10.1007/BF02699784.
The neutral organization that determines the specific beat-to-beat pattern of cardiac behavior is expected to be demonstrated in the independent regulation of the RR intervals (chronotropy) and the corresponding QT subintervals (inotropy), as the former defines the rate of contraction and the latter has a linear negative correlation with the peak pressure inside the contracting ventricular muscles. The neurons of the isolated cardiac nervous system, many of which are located in the fat-pads of the heart, exhibit the same types of mechanical and chemical receptors and the same types of cholinergic and noradrenergic effectors as those found in the neural superstructure. In the surgically isolated and perfused rabbit heart we studied the responses of the QT and RR intervals evoked by block of coronary blood flow. We found that if we separated each RR cycle into QT and RR-QT components, then the dynamics of variation for each subinterval series often had the same fractional number of degrees of freedom (i.e., chaotic dimensions), a finding which suggests they are both regulated by the same underlying system. The ischemia/anoxia evoked transient dimensional increases and separations between the two subinterval series that, after the temporary divergence, reconverged to having the same lower value. The dimensional fluctuations occurred repeatedly and preceded or coincided with alterations in the magnitude and sign of the slope of QT vs RR-QT. We interpret the dimensional fluctuations of the two subinterval series as correlates of adaptation-dependent self-organization and reorganization in the underlying intrinsic cardiac nervous system during accumulating ischemia/anoxia. Such attempts at functional reorganization in this simple neurocardiac system may explain the transient dimensional changes in the RR intervals that precedes by 24 hrs the occurrences of fatal ventricular fibrillation in high-risk cardiac patients.
预期能在RR间期(变时性)和相应QT子间期(变力性)的独立调节中证明决定心脏行为特定逐搏模式的中性组织,因为前者定义收缩速率,而后者与收缩期心室肌内的峰值压力呈线性负相关。孤立心脏神经系统的神经元,其中许多位于心脏脂肪垫中,表现出与神经上层结构中发现的相同类型的机械和化学感受器以及相同类型的胆碱能和去甲肾上腺素能效应器。在手术分离并灌注的兔心脏中,我们研究了冠状动脉血流阻断引起的QT和RR间期的反应。我们发现,如果将每个RR周期分为QT和RR - QT成分,那么每个子间期系列变化的动力学通常具有相同的分数自由度(即混沌维度),这一发现表明它们都受相同的潜在系统调节。缺血/缺氧引起两个子间期系列之间的瞬时维度增加和分离,在暂时分开后,又重新收敛到相同的较低值。维度波动反复出现,并先于或与QT与RR - QT斜率的大小和符号变化同时发生。我们将两个子间期系列的维度波动解释为在累积缺血/缺氧期间潜在的内在心脏神经系统中依赖适应的自组织和重组的相关因素。在这个简单的神经心脏系统中这种功能重组的尝试可能解释了高危心脏患者在致命性心室颤动发生前24小时RR间期的瞬时维度变化。