间断低氧增加心房神经活性和局灶性房颤诱导性：自主神经的重要作用

发布时间：2018-11-04 15:07

【摘要】：背景：近来越来越多的研究发现睡眠呼吸暂停(OSA)和房颤之间存在重要联系,心房自主神经节(GP)可能是其中的重要中间环节。目的：验证间断低氧可导致心房自主神经节(GP)过度激活并促进局灶性房颤发生的假设。方法：多极电极导管缝于心房和所有的肺静脉。调整呼吸机以发出间断低氧刺激1小时制造急性间断低氧模型,分别在各个位点测定基础水平和间歇性低氧1h后该位点的房颤阈值(AF-TH)及心房有效不应期(ERP),1小时间断低氧后在心房起搏(在不应期)之后延迟2ms给予40ms的高频刺激(HFS;200Hz,0.01ms脉宽)以测定AF-TH。一个多极电极置于右前神经节(ARGP)对该位点发出HFS(20Hz,0.1ms脉宽)以诱导窦率(SR)减慢。从ARGP记录神经活性。结果：(1)1小时间歇性低氧诱导的AF-TH, ERP的在所有记录部位均减少(均P0.05)。(2)1小时间歇性缺氧使得刺激ARGP诱导的SR减慢反应易化,提示间断性缺氧增强ARGP功能。(3)1小时间歇性缺氧使得的从ARGP记录神经活动的频率和幅度均显著增加。结论：1小时的间歇性低氧可增加AF诱发性和对副交感神经刺激的变时性反应；这些作用的潜在机制可能是增高GP活性。
[Abstract]:Background: recently, more and more studies have found that there is an important relationship between sleep apnea (OSA) and atrial fibrillation. (GP) may be an important intermediate link in atrial autonomic ganglion. Aim: to test the hypothesis that intermittent hypoxia leads to excessive activation of (GP) in the autonomic ganglion and promotes the occurrence of focal atrial fibrillation. Methods: the multipole electrode catheter was sutured in the atrium and all pulmonary veins. The acute intermittent hypoxia model was established by adjusting the ventilator to emit intermittent hypoxic stimulation for 1 hour. The basal level and atrial fibrillation threshold (AF-TH) at each site and atrial effective refractory period (ERP),) were measured at each site after 1 hour of intermittent hypoxia. 1 hour intermittent hypoxia after atrial pacing (during refractory period) delays high frequency stimulation of 40ms by 2ms (HFS;) Determination of AF-TH. by 200Hz 0. 01 Ms pulse width A multipole electrode was placed in the right anterior ganglion (ARGP) to emit HFS (20 Hz ~ 0. 1 Ms pulse width) to induce sinus rate (SR) to slow down. Nerve activity was recorded from ARGP. Results: (1) 1 hour intermittent hypoxia induced AF-TH, ERP decreased in all recording sites (P0.05). (2) 1 hour intermittent hypoxia facilitated the SR response induced by ARGP. It suggested that intermittent hypoxia enhanced the function of ARGP. (3) the frequency and amplitude of nerve activity recorded from ARGP were significantly increased after 1 hour intermittent hypoxia. Conclusion: intermittent hypoxia for one hour can increase the AF induction and the chronotropic response to parasympathetic nerve stimulation, and the underlying mechanism of these effects may be the increase of GP activity.
【学位授予单位】：武汉大学
【学位级别】：博士
【学位授予年份】：2014
【分类号】：R541.75;R766

【参考文献】