EFFECT OF AUTONOMIC BLOCKADE ON VENTRICULAR REFRACTORINESS AND ATRIOVENTRICULAR NODAL CONDUCTION IN HUMANS - EVIDENCE SUPPORTING A DIRECT CHOLINERGIC ACTION ON VENTRICULAR MUSCLE REFRACTORINESS
EFFECT OF AUTONOMIC BLOCKADE ON VENTRICULAR REFRACTORINESS AND ATRIOVENTRICULAR NODAL CONDUCTION IN HUMANS - EVIDENCE SUPPORTING A DIRECT CHOLINERGIC ACTION ON VENTRICULAR MUSCLE REFRACTORINESS
复制标题
DOI：
10.1161/01.res.49.2.511
复制
发表时间：
1981-01-01
影响因子：
20.1
通讯作者：
ZIPES, DP
中科院分区：
文献类型：
--
作者：
PRYSTOWSKY, EN;JACKMAN, WM;ZIPES, DP
在人类中，副交感神经系统在控制心率方面优于交感神经系统，但关于胆碱能和肾上腺素能紧张对心室和房室（AV）结的电生理特性的相对影响知之甚少。受试者[13]在对照状态和普萘洛尔（0.15 mg/kg，i. v.）+阿托品（0.03mg/kg，i. v.）评估自主神经阻滞对心室和房室结不应性以及房室结传导的影响。8例受试者首次接受普萘洛尔（A组），5例受试者首次接受阿托品（B组）。对于A组和B组，在给予普萘洛尔和阿托品后，自发性窦性周期长度与对照组相比显著缩短[813 . ±-. 107（SD）至613 .+-。57 ms和842 ±. 188至637 .+-. 115 ms）。给予普萘洛尔后，心室有效（ERP）和功能（FRP）不应期与对照组相比无显著增加（A组）; 23到218 .+-. 19 ms和261 ±。22到243 .+-. 17ms）。在B组受试者中，阿托品和普萘洛尔给药后心室不应性发生了类似的结果。给予普萘洛尔和阿托品后维持1：1房室结传导的最短心房起搏周期长度与对照值相比没有显著变化（386 ± 0.05）。109到372 .+-. 74 ms）。静息迷走神经张力显然对人心室不应性具有显著影响，并且该影响可能在β-肾上腺素能阻滞与副交感神经系统对窦房结自律性的显著主导作用相反，迷走神经和肾上腺素能张力对静息AV结传导产生平衡作用。
In humans the parasympathetic nervous system predominates over the sympathetic nervous system in control of heart rate, but little is known about the relative influences of cholinergic and adrenergic tone on the electrophysiological properties of the ventricle and atrioventricular (AV) node. Subjects [13] were studied using standard electrophysiological testing techniques in the control state and after propranolol (0.15 mg/kg, i.v.) plus atropine (0.03 mg/kg, i.v.) to assess the effect of autonomic blockade on ventricular and AV nodal refractoriness and AV nodal conduction. Eight subjects received propranolol 1st (group A) and 5 were given atropine 1st (group B). For groups A and B the spontaneous sinus cycle length significantly decreased from control after administration of propranolol and atropine [813 .+-. 107 (SD) to 613 .+-. 57 ms and 842 .+-. 188 to 637 .+-. 115 ms, respectively]. Ventricular effective (ERP) and functional (FRP) refractory periods insignificantly increased from control after propranolol was given (group A); ventricular ERP and FRP significantly shortened to less than control values after atropine was added (238 .+-. 23 to 218 .+-. 19 ms and 261 .+-. 22 to 243 .+-. 17 ms, respectively). Similar results for ventricular refractoriness occurred after administration of atropine and propranolol in group B subjects. The shortest atrial pacing cycle length sustaining 1:1 AV nodal conduction after administration of propranolol and atropine did not significantly change from control values (386 .+-. 109 to 372 .+-. 74 ms). Resting vagal tone apparently exerts a significant effect on human ventricular refractoriness, and the effect may occur in the presence of .beta.-adrenergic blockade. In contrast to the markedly predominant effect of the parasympathetic nervous system on sinus nodal automaticity, vagal and adrenergic tone exert a balanced effect on resting AV nodal conduction.