Vagus nerve stimulation decreases left ventricular contractility in vivo in the human and pig heart
Vagus nerve stimulation decreases left ventricular contractility in vivo in the human and pig heart
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DOI：
10.1111/j.1469-7793.2001.00547.x
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发表时间：
2001-07-15
影响因子：
5.5
通讯作者：
Coote, JH
中科院分区：
文献类型：
--
作者：
Lewis, ME;Al-Khalidi, AH;Coote, JH
1. 关于迷走神经刺激对哺乳动物心室心肌功能影响的研究有限，特别是在人类中。2．本研究旨在确定在接受冠状动脉旁路移植术开胸手术的麻醉猪和麻醉人体受试者中，左迷走神经直接电刺激对心脏起搏速度高于自然心率 10% 的左心室收缩状态的影响。3．左心室的收缩性是通过一系列压力-容量环确定的，这些压力-容量环是从放置在左心室中的组合压力和电导（容量）导管获得的。根据测量结果，确定收缩末期压力-容积关系的回归斜率，以给出收缩末期弹性（Ees），这是一种与负荷无关的收缩性测量方法。4．在六头麻醉的开胸猪中，刺激左颈迷走神经的外周切口端导致 Ees 显着下降 26 +/- 14 %.5。在 9 名患者中，对靠近其心脏分支的左胸迷走神经进行电刺激导致 Ees 显着下降 38 +/- 16 %.6。迷走神经刺激的作用被毒蕈碱拮抗剂格隆铵(5 mg kg(-1))阻断。7． β-肾上腺素受体拮抗剂艾司洛尔(I mg kg(-1))的给药也减弱了迷走神经刺激的作用，表明迷走神经和交感神经对收缩力的影响有一定程度的相互作用。8．这些研究表明，在人和猪的心脏中，左迷走神经可以显着降低左心室心肌的正性肌力状态，而与其心动过缓效应无关。
1. Studies of the effect of vagus nerve stimulation on ventricular myocardial function in mammals are limited, particularly in the human.2. The present study was designed to determine the effect of direct electrical stimulation of the left vagus nerve on left ventricular contractile state in hearts paced at 10 % above the natural rate, in anaesthetised pigs and anaesthetised human subjects undergoing open chest surgery for coronary artery bypass grafting.3. Contractility of the left ventricle was determined from a series of pressure-volume loops obtained from a combined pressure and conductance (volume) catheter placed in the left ventricle. From the measurements a regression slope of the end-systolic pressure-volume relationship was determined to give end-systolic elastance (Ees), a load-independent measure of Contractility.4. In six anaesthetised open chest pigs, stimulation of the peripheral cut end of the left cervical vagus nerve induced a significant decrease in Ees of 26 +/- 14 %.5. In nine patients electrical stimulation of the left thoracic vagus nerve close to its cardiac branch resulted in a significant drop in Ees of 38 +/- 16 %.6. The effects of vagal stimulation were blocked by the muscarinic antagonist glycopyrronium (5 mg kg(-1)).7. Administration of the beta -adrenoreceptor antagonist esmolol (I mg kg(-1)) also attenuated the effect of vagal stimulation, indicating a degree of interaction of vagal and sympathetic influences on contractility.8. These studies show that in the human and pig heart the left vagus nerve can profoundly decrease the inotropic state of the left ventricular myocardium independent of its bradycardic effect.