Gillis R A, Corr P B, Pace D G, Evans D E, DiMicco J, Pearle D L
Cardiology. 1976;61(1):37-49. doi: 10.1159/000169746.
The purpose of our studies was to examine the role of the nervous system in arrhythmias produced by digitalis overdose and coronary artery occlusion in the cat. This was done by observing the effect of these arrhythmogenic procedures on cardiac efferent neural activity and then determining whether any observed alteration in neural activity contributed to the cardiac rhythm disturbances evoked by digitalis and coronary artery occlusion. Our data indicate that both procedures used to evoke arrhythmias activate each division of the autonomic nervous system. Activation of the sympathetic nervous system resulted in a deleterious effect on cardiac rhythm whereas activation of the parasympathetic nervous system, in general, resulted in a beneficial effect on cardiac rhythm. With coronary occlusion, the role exerted by the nervous system depended on the anatomic location of the involved myocardium. Studies directed at elucidating the mechanisms whereby the nervous system caused cardiac rhythm disturbances indicated that there may be an important difference between the antiarrhythmic efficacy of beta-adrenergic blockade and bilateral stellate ganglionectomy. The latter procedure proved to be a more effective way of removing deleterious sympathetic neural effects on the heart. In conclusion, our findings suggest that the development of new drugs for treating arrhythmias resulting from digitalis and coronary occlusion should be aimed at finding drugs that act to either depress central sympathetic outflow or enhance parasympathetic effects on the ventricle.
我们研究的目的是检验神经系统在猫因洋地黄过量和冠状动脉闭塞所引发的心律失常中所起的作用。通过观察这些致心律失常过程对心脏传出神经活动的影响,然后确定神经活动中任何观察到的改变是否导致了洋地黄和冠状动脉闭塞所诱发的心律失常,来实现这一目的。我们的数据表明,用于诱发心律失常的两种过程均激活了自主神经系统的各个分支。交感神经系统的激活对心律产生有害影响,而副交感神经系统的激活总体上对心律产生有益影响。在冠状动脉闭塞的情况下,神经系统所起的作用取决于受累心肌的解剖位置。旨在阐明神经系统导致心律失常机制的研究表明,β-肾上腺素能阻滞剂和双侧星状神经节切除术的抗心律失常疗效可能存在重要差异。后一种手术被证明是消除交感神经对心脏有害影响的更有效方法。总之,我们的研究结果表明,开发用于治疗洋地黄和冠状动脉闭塞所致心律失常的新药应旨在寻找能够抑制中枢交感神经输出或增强副交感神经对心室作用的药物。