射频消融犬心脏第三脂肪垫消弱Bezold-Jarisch反射  

Radiofrequency catheter ablation of the third cardiac fat pad attenuates the Bezold-Jarisch reflex in dogs.

作　　者：夏阳[1] 杨志健[2] 张家友[2] 赵亮[2] 顾兴建[2] 廖德宁[2] 

机构地区：[1]解放军第101医院心内科,江苏无锡214044 [2]上海长征医院心内科,上海200003

出　　处：《中国心脏起搏与心电生理杂志》2009年第5期433-436,共4页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：国家自然科学基金资助项目(项目编号:30570761)

摘　　要：目的观察射频消融犬心脏第3脂肪垫(上腔静脉与主动脉根部之间的脂肪垫,SVC-AO FP)对Bezold-Jarisch反射(BJR)及相关的血流动力学指标的影响。方法30只杂种犬麻醉后经右侧开胸,随机分为对照组(不消融)、消融组(消融SVC-AO FP),每组15只。经左室导管弹丸式推注藜芦定15μg/kg诱发BJR,比较两组推药前后心率(HR)、动脉压、左室压、左室压最大上升速率(+dp/dtmax)及最大下降速率(-dp/dtmax)的变化。结果推注藜芦定前两组的各项指标无显著差异(P>0.05),推注藜芦定后两组的各项指标均呈一过性下降,消融组HR的最大下降值ΔHR显著低于对照组(27.7±8.2次/分vs 93.3±18.4次/分,P<0.01),但动脉压、左室压及±dp/dtmax的最大下降值两组相比无显著差异(P>0.05)。结论射频消融犬SVC-AO FP能明显消弱藜芦定诱发的BJR的HR抑制,但不能消弱BJR的血管抑制。Objective To observe the effects of radiofrequency catheter ablation （RFCA） on the third cardiac fat pad located between the superior vena cava and aortic root （SVC-AO fat pad） during veratridine-induced the Bezold-Jarisch reflex （BJR） in dogs. Methods Thirty mongrel dogs were anesthetized and right thoracotomies were performed to access the chest cavities. The animals were divided into the control group which received no ablation, and the ablation group which received RFCA of the SVC-AO fat pad. Veratridine was injected into the left ventricle in bolus doses of 15μg/kg through a catheter to induce the BJR. Heart rate （HR）, systolic arterial pressure （SAP）, diastolic arterial pressure （DAP）, mean arterial pressure （MAP）, left ventricle systolic pressure （LVSP）, left ventricle diastolic pressure （LVDP） and left ventricular peak systolic （ ＋ dp/dtmax ） and peak diastolic velocity （ - dp/dtmax） were measured before and after veratridine injection. Results Prior to veratridine injection , there were no significant differences in the baseline values of HR, SAP, DAP, MAP, LVSP, LVEDP and ＋ dp/dtmax between both groups （P 〉 0.05 ）. After injecting veratridine, all the parameters mentioned above temporarily decreased in both groups. The maximum decrement of HR in the ablation group was significantly lower than that in the control group （27.7 ± 8.2bpm vs 93.3± 18.4bpm, P 〈 0.01 ）. However, there were no differences in the maximum decrement of SAP, DAP, MAP, LVSP, LVEDP, ＋ dp/dtmax and - dp/dtmax between both groups （ P 〉 0.05 ）. Conclusions RFCA of the SVC-AO fat pads significantly attenuated veratridine-mediated cardiac inhibitory component of the BJR. However, RFCA did not affect veratridine-mediated vasodepressor component of the B JR. [ Chinese Journal of Cardiac Pacing and Electrophysiology,2009,23 （5） ：433 -436 ]

关 键 词：心血管病学 导管消融 射频电流 心脏脂肪垫 迷走神经节 Bezold—Jarisch反射 

分 类 号：R454.1[医药卫生—治疗学]