Structural atrial remodeling alters the substrate and spatiotemporal organization of atrial fibrillation: a comparison in canine models of structural and electrical atrial remodeling
Structural atrial remodeling alters the substrate and spatiotemporal organization of atrial fibrillation: a comparison in canine models of structural and electrical atrial remodeling
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DOI：
10.1152/ajpheart.01128.2005
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发表时间：
2006-12-01
影响因子：
4.8
通讯作者：
Olgin, Jeffrey E.
中科院分区：
文献类型：
--
作者：
Everett, Thomas H.;Wilson, Emily E.;Olgin, Jeffrey E.
目前已经建立了几种心房颤动（AF）动物模型，表现为心房结构重构或心房电重构，但这些模型之间心房颤动的特征和时空组织尚未进行比较。39只狗被分为5组：快速心房起搏（RAP）组、慢性二尖瓣反流（MR）组、充血性心力衰竭（CHF）组、甲基胆碱（Meth）组和对照组。使用高密度（240个电极）心外膜阵列同时绘制每只动物AF发作时的右心房和左心房（分别为RA和LA）。每只狗记录多个30秒AF期。在滑动的2-s窗口上，每隔1秒计算一次快速傅里叶变换，并确定主导频率（DF）。在RAP组和对照组中，没有一只狗出现稳定的、离散的高频区域，在9只MR组中有4只，在6只CHF组中有4只，在RA组或LA组或两者中，在9只冰毒组中有7只。除RAP模型中LA df外，Meth模型中LA和RA的平均df均显著大于其他所有模型。RAP模型是唯一具有一致的la - ra DF梯度的模型（9.5 +/- 0.2 vs. 8.3 +/- 0.3 Hz, P < 0.00005）。与其他AF模型相比，Meth模型具有较高的DF时空变异和较低的组织水平，是唯一一个DF与离散度呈线性关系的模型（R-2 = 0.86）。这些数据表明，心房结构重构（已知主要改变传导的模型）导致以稳定高频区为特征的房颤，而心房电重构（已知主要缩短耐火度而无显著传导异常的模型）导致以多个高频区和多个小波为特征的房颤。
Several animal models of atrial fibrillation (AF) have been developed that demonstrate either atrial structural remodeling or atrial electrical remodeling, but the characteristics and spatiotemporal organization of the AF between the models have not been compared. Thirty-nine dogs were divided into five groups: rapid atrial pacing (RAP), chronic mitral regurgitation (MR), congestive heart failure (CHF), methylcholine (Meth), and control. Right and left atria (RA and LA, respectively) were simultaneously mapped during episodes of AF in each animal using high-density (240 electrodes) epicardial arrays. Multiple 30-s AF epochs were recorded in each dog. Fast Fourier transform was calculated every 1 s over a sliding 2-s window, and dominant frequency (DF) was determined. Stable, discrete, high-frequency areas were seen in none of the RAP or control dogs, four of nine MR dogs, four of six CHF dogs, and seven of nine Meth dogs in either the RA or LA or both. Average DFs in the Meth model were significantly greater than in all other models in both LA and RA except LA DFs in the RAP model. The RAP model was the only one with a consistent LA-to-RA DF gradient (9.5 +/- 0.2 vs. 8.3 +/- 0.3 Hz, P < 0.00005). The Meth model had a higher spatial and temporal variance of DFs and lower measured organization levels compared with the other AF models, and it was the only model to show a linear relationship between the highest DF and dispersion (R-2 = 0.86). These data indicate that structural remodeling of atria (models known to have predominantly altered conduction) leads to an AF characterized by a stable high-frequency area, whereas electrical remodeling of atria (models known to have predominantly shortened refractoriness without significant conduction abnormalities) leads to an AF characterized by multiple high-frequency areas and multiple wavelets.