射频消融犬右肺静脉脂肪垫消弱Bezold-Jarisch反射  

Radiofrequency ablation of cardiac fat pad at right pulmonary vein-atria junction attenuates Bezold-Jarisch reflex in canine

作　　者：赵伟[1] 廖德宁[1] 夏阳[1] 赵学[1] 张家友[1] 顾兴建[1] 

机构地区：[1]第二军医大学长征医院心血管内科,上海200003

出　　处：《第二军医大学学报》2007年第12期1335-1338,共4页Academic Journal of Second Military Medical University

基　　金：国家自然科学基金(30570761)~~

摘　　要：目的:观察射频消融犬右肺静脉(RPV)脂肪垫对Bezold-Jarisch反射(BJR)的影响。方法:选用10只杂种犬麻醉后经右侧开胸,暴露RPV脂肪垫,测定基础状态下窦性周长(SCL)、动脉收缩压(SAP)、动脉舒张压(DAP)、平均动脉压(MAP)、左心室收缩压(LVSP)、左心室舒张压(LVDP)、左心室平均压(MLVP);经左心室导管弹丸式推注藜芦定(每kg体质量10μg)诱发BJR,观察上述指标的变化,计算各指标的变化值(△SCL、△SAP、△DAP、△MAP、△LVSP、△LVDP、△MLVP);射频消融RPV脂肪垫后推注相同剂量藜芦定,再次观察上述指标的变化值。结果:8只犬顺利完成实验,左心室推注藜芦定后均诱发出BJR,表现为SCL延长,动脉压及左室压下降。与消融前推注藜芦定相比,RPV脂肪垫消融后△SCL(ms)显著减小(229.2±92.3vs 39.3±14.1,P<0.01),△DAP、△MAP亦显著减小(P<0.05),其余变化值虽有所减少,但无统计学差异。结论:射频消融犬RPV脂肪垫明显消弱了藜芦定诱发BJR时的心率下降,减弱了动脉舒张压及平均压的降低。Objective：To observe the influence of radiofrequency catheter ablation of the fat pad at the right pulmonary veinatria junction （RPV fat pad） on Bezold-Jarisch reflex （BJR） induced by veratridine in canine. Methods： Ten mongrel dogs were anesthetized and their chest were opened through a right thoracotomy to expose the RPV fat pad. Veratridine was injected into the left ventricle at bolus doses of l0 μg/kg through a catheter to induce BJR. The sinus cycle length （SCL）, systolic arterial pressure （SAP）, diastolic arterial pressure （DAP）, mean arterial pressure （MAP）, left ventricle systolic pressure （LVSP）, left ventricle diastolic pressure （LVDP） and mean left ventricle pressure （MLVP） were measured under the baseline and after ablation of the RPV fat pad; the changes of the above parameters （ASCL, ASAP, ADAP, AMAP, ALVSP, ALVDP, and AMLVP） were calculated. Then the same dose of veratridine was injected under the pad after ablation and the changes of the above parameters were observed. Results： BJR was successfully induced in the 8 animals; the animals has prolonged sinus cycle length （SCL） and decreased MAP and MLVP. After ablation, the prolongation of SCL after injection of veratridine was markedly reduced （[229.2±92.3] ms vs [39.3±14.1] ms,P〈0.01）. All the pressures were decreased after injection of veratridine, with significant decrease found only for DAP and MAP （both P〈0.05）. Conclusion： Ablation of the RPV fat pad can effectively attenuate the decrement of heart rate and the decrement of DAP and MAP during the BJR induced by veratridine, which provides a basis for the radiofrequency catheter ablation of vagus ganglions through endocardium.

关 键 词：导管消融术 心脏脂肪垫 肺静脉 Bezold—Jarisch反射 

分 类 号：R543[医药卫生—心血管疾病]