非兴奋性电刺激对正常及心肌梗死兔心功能的影响及其作用的局部性

目的:观察于绝对不应期发放电刺激对正常和心肌梗死(MI)兔在体心脏心功能的影响及其对心肌作用的局部性。方法:64只家兔随机分为正常组和MI组两大组,每组又分为前壁和后壁两组。复制MI模型,4周后每组开胸,窦性心律下,分别于前壁组和后壁组的左心室前壁和后壁,发放绝对不应期方波电刺激(CCM)。观察左心室收缩压(LVSP)左心室舒张末压(LVEDP)及其微分(±dp/dt_max)的变化。结果:正常组前壁和后壁CCM刺激时LVSP及+dp/dt_max均显著大于刺激前(P<0.05),LVEDP低于、-dp/dt_max负值大于刺激前(P<0.05),且不同部位的CCM刺激对心功能的影响不同,左心室前壁的上述作用大于后壁(P<0.05);MI组前壁和后壁CCM刺激时LVSP及+dp/dt_max亦大于刺激前(P<0.05),LVEDP低于、-dp/dt_max负值亦大于刺激前(P<0.05),但前后壁两组之间无显著差别(P＞0.05)。结论:于绝对不应期发放电刺激能明显增强正常和MI后心肌的收缩和舒张功能,CCM刺激对心肌的作用是局部性的。

Effects of non-excitatory electric stimulation on cardiac function in normal andinfarcted heart rabbits and it''s regional effect on myocardium

AIM: To investigate the influences of electric stimulation applied during the absolute refractory period (ARP) on the cardiac function of normal rabbits and rabbits after myocardial infarction (MI) and to observe the regional effects of this electric stimulation. METHODS: 64 rabbits were randomly assigned to normal and MI groups and each group was then divided into the anterior and posterior groups. A thoracotomy was performed 4 weeks after MI in rabbits. One set of electrodes was inserted into the anterior and posterior wall of left ventricle of the anterior and posterior groups, respectively. Current pulses were delivered during the ARP (called CCM) during sinus rhythm in rabbits. The left ventricular systolic pressure (LVSP) and the left ventricular end diastolic pressure(LVEDP) as well as maximum positive and negative left ventricular pressure change (±dp/dt_max) were observed. RESULTS: In the normal and MI groups, LVSP, +dp/dt_max significantly increased, and LVEDP, -dp/dt_max were reduced during CCM stimulation compared with the baseline (P<0.05). In the normal rabbits, electric stimulation in the anterior group improved the cardiac function more significantly than that in the posterior group (P<0.05). In the MI rabbits, there was no difference between the anterior and the posterior groups (P>0.05). CONCLUSION: Electric stimulation delivered during the ARP significantly enhances the contractility and the relaxation of myocardium in normal rabbits and rabbits after MI, and the effects of CCM stimulation on heart are regional.