Optical mapping of the isolated coronary-perfused human sinus node.
Optical mapping of the isolated coronary-perfused human sinus node.
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DOI：
10.1016/j.jacc.2010.03.098
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发表时间：
2010-10-19
影响因子：
24
通讯作者：
Efimov, Igor R.
中科院分区：
文献类型：
--
作者：
Fedorov, Vadim V.;Glukhov, Alexey V.;Chang, Roger;Kostecki, Geran;Aferol, Hyuliya;Hucker, William J.;Wuskell, Joseph P.;Loew, Leslie M.;Schuessler, Richard B.;Moazami, Nader;Efimov, Igor R.
人类窦房结 (SAN) 内的起源位置和激发模式尚未直接绘制。我们假设人类 SAN 在功能上与周围的心房心肌隔离，除了几个电桥接节点组织和心房心肌的出口通路之外。使用染料 Di-4-ANBDQBS 和布雷他汀在来自非衰竭人类心脏（n=4，年龄 54±15 岁）的冠状动脉灌注制剂中对 SAN 进行光学映射。使用组织学重建 SAN 3D 结构。 SAN 的光学记录具有舒张期去极化和多个上冲成分，这对应于 SAN 和心房层的单独激发。激发起源于 SAN 中部 (66±17 BPM)，然后缓慢地 (1–18 cm/s) 且各向异性地传播。 SAN 内 82±17 ms 传导延迟后，心房心肌通过上窦房传导通路、中窦房传导通路和/或下窦房传导通路兴奋。心房兴奋在距主起搏器位置 9.4±4.2 mm 处启动。除这些通路外，椭圆形 14.3±1.5 × 6.7±1.6 × 1.0±0.2 mm SAN 结构通过结缔组织、脂肪和冠状动脉与心房功能隔离。这些数据首次展示了主要 SAN 起搏器部位的位置、人体 SAN 内的激发模式以及进入右心房的传导路径。这些通路的存在解释了为什么即使在正常窦性心律期间，心房突破也可能来自与 CT 平行的区域，该区域明显大于解剖学上定义的 SAN 区域 (26.0±7.8 mm)。
The site of origin and pattern of excitation within the human sinoatrial node (SAN) has not been directly mapped. We hypothesized that the human SAN is functionally insulated from the surrounding atrial myocardium except for several exit pathways which electrically bridge the nodal tissue and atrial myocardium. The SAN was optically mapped in coronary perfused preparations from non-failing human hearts (n=4, age 54±15 years) using dye Di-4-ANBDQBS and Blebbistatin. SAN 3D structure was reconstructed using histology. Optical recordings from the SAN had diastolic depolarization and multiple upstroke components, which corresponded to the separate excitations of the SAN and atrial layers. Excitation originated in the middle of the SAN (66±17 BPM), then slowly (1–18 cm/s) and anisotropically spread. After a 82±17 ms conduction delay within the SAN, the atrial myocardium was excited via superior, middle, and/or inferior sinoatrial conduction pathways. Atrial excitation was initiated 9.4±4.2 mm from the leading pacemaker site. The oval 14.3±1.5 × 6.7±1.6 × 1.0±0.2 mm SAN structure was functionally insulated from the atrium by connective tissue, fat, and coronary arteries, except for these pathways. These data demonstrated for the first time the location of the leading SAN pacemaker site, the pattern of excitation within the human SAN, and the conduction pathways into the right atrium. The existence of these pathways explained why, even during normal sinus rhythm, atrial breakthroughs could arise from a region parallel to the CT that is significantly larger (26.0±7.8 mm) than the area of the anatomically defined SAN.
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影响因子：
20.1
作者：
Nikoski, V;Efimov, IR
通讯作者：
Efimov, IR
影响因子：
5.5
作者：
Fedorov, Vadim V.;Lozinsky, Ilya T.;Efimov, Igor R.
通讯作者：
Efimov, Igor R.
影响因子：
37.8
作者：
DURRER, D;VANDAM, RT;ARZBAECHER, RC
通讯作者：
ARZBAECHER, RC
DOI：
10.1046/j.1540-8167.2004.03403.x
发表时间：
2004-05-01
影响因子：
2.7
作者：
Cosío, FG;Martín-Peñato, A;Schames, S
通讯作者：
Schames, S
影响因子：
20.1
作者：
Efimov IR;Fedorov VV;Joung B;Lin SF
通讯作者：
Lin SF