TOTAL EXCITATION OF ISOLATED HUMAN HEART
TOTAL EXCITATION OF ISOLATED HUMAN HEART
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DOI：
10.1161/01.cir.41.6.899
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发表时间：
1970-01-01
期刊：
影响因子：
37.8
通讯作者：
ARZBAECHER, RC
中科院分区：
文献类型：
--
作者：
DURRER, D;VANDAM, RT;ARZBAECHER, RC
为了获得有关正常人心脏兴奋过程的时间进程和瞬时分布的信息，对7个死于各种脑疾病但没有心脏病史的人的离体心脏进行了研究。在离体人心脏上，左心室活动电位开始后0 ~ 5毫秒，三个内膜区同步兴奋。在接下来的5至10毫秒内，这些区域的大小迅速增加，并在15至20毫秒内汇合。首先兴奋的左心室区域是：（1）二尖瓣附着点下方的前室间隔旁壁;（2）室间隔左表面中央;（3）后室间隔旁，约心尖至基底距离的1/3。左心室最后被激活的部位通常是后基底区。发现右心室的内皮素激活在左心室腔电位开始后5至10毫秒的前乳头肌插入附近开始。室间隔激活开始于室间隔左侧的中间三分之一，略向前，在室间隔和后壁交界处的下三分之一。心外膜兴奋模式反映了壁内兴奋波的运动。通过适当的刺激技术在一个心脏中测定传导速度。心房兴奋，探讨了两个心脏，传播或多或少根据同心等时线。对照研究，进行了5只犬的心脏，披露的模式心室兴奋隔离和灌注后没有改变。然而，在离体心脏中，完全兴奋较早完成，传导速度增加。
To obtain information concerning the time course and instantaneous distribution of the excitatory process of the normal human heart, studies were made on isolated human hearts from seven individuals who died from various cerebral conditions, but who had no history of cardiac disease. Measurements were made from as many as 870 intramural terminals.In the isolated human hearts three endocardial areas were synchronously excited 0 to 5 msec after the start of the left ventricular activity potential. These areas increased rapidly in size during the next 5 to 10 msec and became confluent in 15 to 20 msec. The left ventricular areas first excited were (1) high on the anterior paraseptal wall just below the attachment of the mitral valve; (2) central on the left surface of the interventricular septum and (3) posterior paraseptal about one third of the distance from apex to base. The last part of the left ventricle to be activated usually was the posterobasal area. Endocardial activation of the right ventricle was found to start near the insertion of the anterior papillary muscle 5 to 10 msec after onset of the left ventricular cavity potential. Septal activation started in the middle third of the left side of the interventricular septum, somewhat anteriorly, and at the lower third at the junction of the septum and posterior wall. The epicardial excitation pattern reflected the movements of the intramural excitation wave. Conduction velocity was determined in one heart by an appropriate stimulation technic. Atrial excitation, explored in two hearts, spread more or less according to concentric isochronic lines.Control studies, carried out on five canine hearts, disclosed that the pattern of ventricular excitation did not change after isolation and perfusion. However, total excitation was completed earlier in the isolated heart, and conduction velocity increased.Careful mapping illustrations are presented.