Effects of complex cardiac architecture on spiral reentry dynamics

复杂心脏结构对螺旋折返动力学的影响

• 批准号: 14207034
• 负责人: KODAMA Itsuo
• 金额: $ 25.13万
• 依托单位: Nagoya University
• 依托单位国家: 日本
• 项目类别: Grant-in-Aid for Scientific Research (A)
• 财政年份: 2002
• 资助国家: 日本
• 起止时间: 2002 至 2004
• 项目状态: 已结题
• 来源: https://kaken.nii.ac.jp/grant/KAKENHI-PROJECT-14207034/
• 关键词: Arrhythmia; Reentry; Optical mapping; Action potential; Anisotropic conduction; Antiarrhythmic drug; スパイラルリエントリー; 心室細動; 心室頻拍; 坑不整脈薬; amiodarone; nifekalant; 興奮間隙

Spiral-type reentrant excitation is a principal mechanism for the genesis of various life-threatening ventricular tachyarrhythmias including ventricular fibrillation and tachycardia. We have developed a new high-resolution optical mapping system equipped with a C-MOS-type digital high-speed video camera to investigate dynamics of spiral-type excitations during ventricular tachyarrhythmias in a two-dimensional thin myocardial layer (1 mm thick) of ventricles of isolated Langendorff-perfused rabbit hearts with endocardial cyoablation. Pharmacological modulation of spiral-type reentry by antiarrhythmic drugs was also investigated. During ventricular tachyarrhythmias induced by cross-field DC stimulation, spiral-type excitations rotating sound a line of functional block were often observed. Dynamics of spiral reentry was primarily determined by "leading-circle"-type electronic interactions of reentrant excitations and wave front curvature-dependent modulation of the safety margin for condu … More ction (curvature effect) as well as architecture of the myocardium showing uniform anisotropy. A decrease in myocardial excitability by Na channel blockade caused a prolongation of the functional line of block, a slowing of reentrant excitations. Spiral-type excitations were more organized with appreciable spatial and temporal excitable gaps after Na channel blockade. On the other hand, spiral-type excitations under K channel blockade was characterized by chaotic meandering with a prolonged line of functional block and frequent wave break-ups via wave front-to-tail interactions as well as early spontaneous termination. These effects of K channel blockade are expected to be effective in preventing formation of stable spiral reentry but may facilitate transition from ventricular tachycardia to fibrillation. These results obtained form this study may provide useful information for the development of new strategy in effective prevention and termination of life-threatening ventricular tachyarrhythmias. Less

螺旋型折返性兴奋是各种危及生命的室性快速性心律失常（包括室颤和心动过速）的主要发生机制。我们已经开发了一种新的高分辨率光学标测系统，配备了C-MOS型数字高速摄像机，以研究在二维薄心肌层（1 mm厚）的离体Langendorff灌注兔心脏的心室内循环消融的室性快速性心律失常过程中螺旋型兴奋的动力学。螺旋型折返的药理学调制抗肿瘤药物也进行了研究。在交叉场直流电刺激诱发室性心律失常时，常可观察到旋转声的螺旋型兴奋和功能阻滞线。螺旋再入动力学主要由再入激发的“引导圆”型电子相互作用和波前曲率对再入安全裕度的调制决定。 ...更多信息 曲率效应（曲率效应）以及心肌的结构显示出均匀的各向异性。钠通道阻滞引起的心肌兴奋性降低导致阻滞功能线延长，折返性兴奋减慢。螺旋型的兴奋更有组织的明显的空间和时间的兴奋间隙后，钠通道封锁。另一方面，在K通道阻断下的螺旋型激发的特征在于具有延长的功能阻断线的混沌蜿蜒和通过波的前端到尾部相互作用的频繁波破裂以及早期自发终止。预期K通道阻滞的这些作用可有效防止稳定螺旋折返的形成，但可能促进室性心动过速向纤颤的转变。本研究结果可为制定有效预防和终止危及生命的室性快速心律失常的新策略提供有用的信息。少

项目成果

Harumichi Nakagawa et al.: "Virtual electrode polarization-induced reentrant activity"Environmental Medicine. 47. 62-65 (2003)

Harumichi Nakakawa 等：“虚拟电极极化诱导的折返活性”环境医学。

Combined effects of nifekalant and lidocaine on life-threatening arrhythmias : changes in the action potential analyzed analyzed using an optical mapping technique(in Japanese)

尼非卡兰和利多卡因对危及生命的心律失常的联合作用：使用光学映射技术分析动作电位的变化（日语）

• 发表时间: 2004
• 期刊: Progress in Medicine 24
• 作者: Amino M et al.

山本 充 他: "心室スパイラル・リエントリーに対するI群坑不整脈薬の作用"Progress in Medicine. 22. 2563-2570 (2002)

Mitsuru Yamamoto 等人：“I 类抗心律失常药物对心室螺旋折返的影响”医学进展 22. 2563-2570 (2002)。

柴田 仁太郎 他: "心室細動と除細動のメカニズム"ICUとCCU. 26. 233-240 (2002)

Jintaro Shibata 等人：“心室颤动和除颤的机制”ICU 和 CCU。26. 233-240 (2002)

Motoki Nihei et al.: "Na^+ channel blockade causes a prolongation of electrical diastole during spiral-type reentry in the ventricle"Environmental Medicine. 46. 103-106 (2002)

Motoki Nihei 等人：“Na + 通道阻断导致心室螺旋型折返期间电舒张期延长”环境医学。