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自主神经系统阻断对经肺静脉短阵快速起搏犬心房急性电重构的影响(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2006年第2期
页码:
159-161
栏目:
基础研究
出版日期:
2006-03-01

文章信息/Info

Title:
Effects of autonomic blockade on acute atrial electrical remodeling induced by shortterm rapid pacing from pulmonary vein
作者:
洪昌明; 郑强荪; 卢延生; 何勇; 刘雄涛
第四军医大学唐都医院心脏内科, 陕西 西安 710038
Author(s):
HONG Chang-ming; ZHENG Qiang-sun; LU Yan-sheng; HE Yong; LIU Xiong-tao
Department of Cardiology，Tangdu Hospital，Fourth Military Medical University，Xi′an,Shaanxi 710038, China
关键词:
心房颤动; 电重构; 自主神经阻断; 肺静脉
Keywords:
atrial fibrillation;  acute electrical remodeling;  autonomic blockade;  pulmonary veins
分类号:
R541.75
DOI:
-
文献标识码:
A
摘要:
目的 探讨阻断自主神经系统对经肺静脉快速起搏造成的急性电重构的影响。 方法成年杂种犬22只，随机分为对照组、阿托品组、美托洛尔组和阿+美组。首先测量起搏周长（PCL）分别为350 ms、400 ms时心房有效不应期（AERP），以能够1∶1起搏肺静脉的最快频率刺激肺静脉10 min，在刺激中止后即刻、5、10、15、20 min时重复测量AERP。比较各组在起搏前后AERP和AERP频率适应性的变化。结果短阵快速肺静脉刺激可引起AERP明显缩短，AERP频率适应性下降，阻断迷走神经后明显减小电重构的程度。结论阻断迷走神经能明显减小短阵快速肺静脉刺激造成的心房电重构的程度。
Abstract:
AIM To assess the effect of autonomic blockade on acute electric remodeling induced by shortterm rapid pacing from pulmonary vein. METHODS Twenty two adult hybrid dogs were divided into 4 groups. First basic atrial effective refractory period (AERP) was measured (pacing cycle length=400 ms,350 ms). Secondly, pulmonary veins were paced for ten minutes using maximum 1∶1 frequency. Then AERP was measured immediately, 5, 10, 15 and 20 minutes respectively. RESULTS Shortterm rapid pacing from pulmonary vein resulted in the shortening of AERP and decrease of AERP rate adaptability. Autonomic blockade could decrease the degree of the acute atrial electric remodeling, mainly by vagus blockade. CONCLUSION Vagus nerve blockade decreases the degree of the acute atrial electric remodeling induced by shortterm rapid pacing from pulmonary vein.

参考文献/References

［1］Sticherling C, Oral H, Horrocks J，et al. Effects of digoxin on acute atrial refractoriness［J］. Cirulation，2000，102:2503-2508

［2］ Haissaguerre M, Jais P, Shah DC, et al. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins［J］. N Engl J Med，1998，339:659-666.

［3］ Kanoupakis EM, Marios EG, Mavrakis HE， et al. Relation of autonomic modulation to recarrence of atrial fibrillation folloming cardioversion［J］. Am J Cardiol， 2000， 86: 954-958.

［4］ Miyauchi M,Yoshinori K,Yasushi M, et al. Parasympathetic blockade promotes recovery from atrial remodeling induced by shortterm rapid atrial pacing［J］. PACE， 2004，27:33-37.

［5］ Huang CX,Zhao QY,Jiang H, et al. Experimental study of the effect of the vagus nerve on atrial electrical remodeling［J］. J Electrocardio， 2003，36：295-300.

［6］ Cheny YJ,Chen SA,Tai CT, et al. Role of atrial electrophysiology and autonomic nervous system in patients with supraventricular tachycardia and paroxysmal atrial fibrillation［J］. J Am Coll Cardiol， 1998，32:732-738.

［7］ Sharifov OF, Fedorov VV, Beloshapko GG, et al. Roles of adrenergic and cholinergic stimulation in spontaneous atrial fibrillation in dogs［J］. J Am Coll Cardiol， 2004，43:483-490.

备注/Memo

备注/Memo:
收稿日期：2004-11-15.基金项目：军队“十五”医药卫生科研基金项目资助（No.01MB126）作者简介：洪昌明，医师，硕士生 Tel：(029)84777722 Email：damingguoji@163.com
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