SELECTIVE VAGAL INNERVATION OF SINOATRIAL AND ATRIOVENTRICULAR NODES IN CANINE HEART
SELECTIVE VAGAL INNERVATION OF SINOATRIAL AND ATRIOVENTRICULAR NODES IN CANINE HEART
复制标题
DOI：
10.1152/ajpheart.1986.251.4.h764
复制
发表时间：
1986-10-01
影响因子：
--
通讯作者：
RANDALL, WC
中科院分区：
文献类型：
--
作者：
ARDELL, JL;RANDALL, WC
从主要心脏血管周围的连续、限制性心包内解剖确定介导对颈部迷走神经刺激的变时性和变频性反应的副交感神经通路。虽然右颈迷走神经输入诱发的心动过缓显着更大，超最大电刺激任一迷走神经产生相似的心室率，同时心房起搏和不同步。解剖下腔静脉下左心房（IVC-ILA）交界处的三角形脂肪垫总是会消除所有对房室（AV）结区域的迷走神经输入。然而，IVC-ILA解剖对颈迷走神经或星状神经节刺激的诱发变时性反应的影响最小。来自右迷走神经或左迷走神经的各自心包内投射通路足够不同，以允许窦房（SA）和房室（AV）结区域的单侧副交感神经去神经支配。左迷走神经投射到SA和AV结区域的路线主要是沿着，并经过右肺动脉和左上级肺静脉。右迷走神经向SA和AV结区域的投射更加弥散，但集中在右肺静脉复合体和右肺动脉的相邻节段周围。我们的结论是有平行的，但功能不同，输入从右和左迷走神经的SA和AV结区。
Parasympathetic pathways mediating chronotropic and dromotropic responses to cervical vagal stimulation were determined from sequential, restricted, intrapericardial dissection around major cardiac vessels. Although right cervical vagal input evoked significantly greater bradycardia, supramaximal electrical stimulation of either vagus produced similar ventricular rates, both with and without simultaneous atrial pacing. Dissection of the triangular fat pad at the junction of the inferior vena cava inferior left atrium (IVC-ILA) invariably eliminated all vagal input to the atrioventricular (AV) nodal region. Yet IVC-ILA dissection had minimal influence on evoked-chronotropic responses to either cervical vagal or stellate ganglia stimulation. Respective intrapericardial projection pathways, from either right or left vagi, are sufficiently distinct to allow unilateral parasympathetic denervation of the sinoatrial (SA) and atrioventricular (AV) nodal regions. Left vagal projections to the SA and AV nodal regions course primarily along and been the right pulmonary artery and left superior pulmonary vein. Right vagal projections to the SA and AV nodal regions are somewhat more diffuse but concentrate around the right pulmonary vein complex and adjacent segments of the right pulmonary artery. We conclude there are parallel, yet functionally distinct, inputs from right and left vagi to the SA and AV nodal regions.