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El infarto ventricular derecho causa una denervación autónoma heterogénea del área periinfarto viable
1University Hospital Utrecht, Heart Lung Institute, Department of Cardiology, The Netherlands.
Circulation
|March 7, 1998
Resumen
El infarto del miocardio ventricular derecho (IVMR) causa una denervación simpática y vagal significativa en las áreas viables del ventrículo derecho. Esta disfunción autónoma, particularmente en el tracto de flujo de salida ventricular derecho, puede aumentar el riesgo de taquiarritmias ventriculares post-RVMI.
Área de la Ciencia:
- Fisiología cardiovascular fisiología cardiovascular.
- El sistema nervioso autónomo.
- Electrofisiología Cardíaca Electrofisiología cardíaca.
Sus antecedentes:
- Las vías autónomas eferentes al ventrículo derecho (RV) difieren de las del ventrículo izquierdo (LV).
- Comprender el impacto del infarto de RV en la inervación cardíaca es crucial debido a estas diferencias.
Objetivo del estudio:
- Para evaluar los efectos del infarto del miocardio ventricular derecho (IVMR) en la inervación simpática y vagal del VVR.
- Para investigar la contribución potencial de la denervación autónoma de RV a las arritmias ventriculares.
Principales métodos:
- Los cambios medidos en el período refractario ventricular efectivo (ERP) en respuesta a la estimulación autónoma antes y después de RVMI en perros.
- IMRV inducida mediante ligadura coronaria o inyección intracoronaria de látex.
- Se evaluó la inervación simpática a través de la estimulación de las subclávias ansae y la inervación vagal a través de la estimulación vagal.
Principales resultados:
- La RVMI condujo a un acortamiento reducido o ausente de la ERP mediada por el simpático en el tracto de salida de RV (RVOT), los sitios laterales y septal.
- El alargamiento de la ERP inducido por la estimulación vagal se atenuó o se perdió en estas áreas después de RVMI.
- El acortamiento de la ERP inducido por la norepinefrina permaneció presente, lo que indica una respuesta adrenérgica preservada en algunas áreas.
Conclusiones:
- RVMI causa denervación simpática y vagal significativa en las regiones periinfarto viables de la RV, incluido el RVOT.
- La denervación autónoma en el RVOT después de RVMI puede contribuir al desarrollo de taquiarritmias ventriculares.
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