跨心肌激光重血管化在慢性情况下重塑内在心脏神经系统
R C Arora1, G M Hirsch, K Hirsch
1Department of Surgery, Dalhousie University, Halifax, Nova Scotia, Canada. rca72@hotmail.com
Circulation
|September 25, 2001
概括
透心肌激光再血管 (TMLR) 重塑了内在心脏神经系统 (ICNS),降低了对尼古丁的反应能力. 这种神经重塑可能解释了在TMLR后耐性心痛患者中观察到的延迟症状缓解.
科学领域:
- 心脏病学 心脏病学
- 神经科学是一个神经科学.
- 手术创新 在外科创新.
背景情况:
- 透心肌激光再血管 (TMLR) 提供了耐火性心痛的症状缓解.
- 延迟的有效性表明潜在的神经机制,可能是心室肌.
- 之前的研究表明TMLR不会急性地削弱心脏或改变内在心脏神经系统 (ICNS).
研究的目的:
- 调查TMLR对ICNS的长期影响.
- 为了确定TMLR是否会随着时间的推移诱导心室缩.
- 探索TMLR诱导的神经变化与症状缓解之间的关系.
主要方法:
- 在10只狗身上使用holmium:yttrium-aluminum-garnet激光器创建了20个心肌过渡通道.
- 在TMLR后四周评估ICNS功能.
- 通过电气/化学刺激 (尼古丁) 来研究心脏感官输入,使用维拉特里丁和异性神经元反应.
主要成果:
- 维拉特里丁的应用引起了预期的ICNS激发反应.
- 对交感和副交感异性神经元的电刺激产生了预期的心脏反应.
- ICNS对全身注射尼古丁的反应显著减弱.
结论:
- 慢性TMLR不会影响心脏 afferent或心脏外 efferent神经元功能.
- 在TMLR中,它是最重要的.
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