Reaction of the nodose ganglion neurons to myocardial ischemia complicated by ventricular fibrillation

Standard microelectrode techniques were used to study the impulse activity of different types of nodosal ganglion neurons. Differences in electrical activity of cardiovascular neurons were observed in myocardial ischemia both complicated and not complicated by fibrillation. In these conditions rhythmic activity of cardiopulmonary, late inspiratory and inspiratory-expiratory neurons is quite similar.     

Adenosine A1 receptor activation reduces myocardial reperfusion effects on intrinsic cardiac nervous system

The intrinsic cardiac nervous system is the final common integrator of regional cardiac function. The ischemic myocardium modifies this nervous system. We sought to determine the role that intrinsic cardiac neuronal P(1) purinergic receptors play in transducing myocardial ischemia and the subsequent reperfusion. The activity generated by ventricular neurons was recorded concomitant with cardiac hemodynamic variables in 44 anesthetized pigs. Regional ventricular ischemia was induced by briefly occluding (30 s) the ventral interventricular coronary artery distal to the arterial blood supply of identified ventricular neurons. Adenosine (100 microM) was administered to these neurons via their local arterial blood supply during or immediately after transient coronary artery occlusion. Occlusion was also performed following local administration of adenosine A(1) [8-cyclopentyl-1,3-dipropylxanthine (DPCPX)] or A(2) [3,7-dimethyl-1-propargylxanthine (DMPX)] receptor blocking agents. The activity generated by ventricular neurons was modified by transient coronary artery occlusion and the subsequent reperfusion (||Delta|| 112 +/- 14 and 168 +/- 34 impulses/min, respectively; P < 0.01 vs. preischemic states). Locally administered adenosine attenuated neuronal responses to reperfusion (-75%; P < 0.01 compared with normal reperfusion) but not ischemia. The neuronal stabilizing effects that adenosine elicited during reperfusion persisted in the presence of DMPX but not DPCPX. It is concluded that activation of neuronal adenosine A(1) receptors stabilizes the intrinsic cardiac nervous system during reperfusion.     

Interrelation of heart rhythm disorders in acute myocardial ischemia with the activity of the limbic and noradrenergic systems

Experiments on white rats were made to study the time-course of the electric activity in the limbic structures and Locus Coeruleus (LC) under ligation of the coronary artery, and the effect of the coagulation of these structures on heart rhythm disorders in acute myocardial ischemia. It was established that during the period that preceded the development of heart rhythm disorders, the most conspicuous changes were seen in the electric activity of the anterior amygdaline nucleus and LC, whereas the coagulation of the amygdalae prevented to a considerable measure development of different forms of arrhythmia. The authors suggest that in acute myocardial ischemia, these structures are directly related to heart rhythm disorders, while the LC is likely to play a role of the hyperactive determinant structure.     

An increase of cathepsin D activity in cardiac lymph and pericadial fluid induced by experimental myocardial ischemia in the dog.

Cathepsin D activity was measured in the cardiac lymph, pericardial fluid and plasma after ligation of the left coronary artery of the dog. The activity of cathepsin D increased both in the cardiac lymph and the pericardial fluid after the coronary ligation, while that in the plasma did not show any increase. In sham operated group, there was practically no change in the cathepsin D activity. The increase in the cathepsin D activity in the cardiac lymph and the pericardial fluid may indicate an increase in amount of myocardial lysosomal enzymes liberated into the interstitial space during myocardial ischemia.     

Impulse activity of bulbar respiratory neurons in myocardial ischemia in cats

Acute experiments on cats anesthetized with nembutal, using a microelectrode technique, have demonstrated that pinching of the coronary artery involves changes in the patterns of impulse activity in all types of bulbar respiratory neurons, up to the appearance of ischemic shifts on the ECG. Progression of myocardial ischemia is paralleled by changes in all the bulbar respiratory neurons.     

Effect of electrostimulation of the dorsolateral funiculus of the spinal cord on changes in the cardiac rhythm in acute myocardial ischemia

The experiments were carried out on inbred white male rats. Cardiac rhythm changes revealed in acute myocardial ischemia under conditions of electrostimulation (ES) of descending sympathicoinhibitory pathways, constituting part of spinal dorsolateral funiculi (DLF) were studied. 10-min stimulation of DLF, started immediately after ligation of the left coronary artery, checked the development of severe cardiac arrhythmia, or considerably weakened the already existing one. The data obtained substantiate the assumption that the onset of cardiac arrhythmia in acute ischemia is associated with the involvement of sympathic preganglionic neurons into the pathologic system, which may be suppressed by the activation of the functionally opposite systems.     

Electrocardiography as a tool for validating myocardial ischemia-reperfusion procedures in mice

This paper evaluates the modifications induced by ischemia and ischemia-reperfusion in mice after permanent or transient, respectively, ligation of the left coronary artery and establishes a correlation among the extent of ischemia, electrocardiograph features, and infarct size. The left coronary artery was ligated 1 mm distal from the tip of the left auricle. Histologic analysis revealed that 30-min ischemia (n = 9) led to infarction involving 9.7% ± 0.5% of the left ventricle, whereas 1-h ischemia (n = 9) resulted in transmural infarction of 16.1% ± 4.6% of the left ventricle. In contrast, 24-h ischemia (n = 8) and permanent ischemia (n = 8) induced similarly sized infarcts (33% ± 2% and 31.8% ± 0.7%, respectively), suggesting ineffective reperfusion after 24-h ischemia. Electrocardiography revealed that ligation of the left coronary artery led to ST height elevation (204 compared with 14 μV) and QTc prolongation (136 compared with 76 ms). Both parameters rapidly normalized on reperfusion, demonstrating that electrocardiography was important for validating correct ligation and reperfusion. In addition, electrocardiography predicted the severity of the myocardial damage induced by ischemia. Our results show that electrocardiographic changes present after 30-min ischemia were reversed on reperfusion; however, prolonged ischemia induced pathologic electrocardiographic patterns that remained even after reperfusion. The mouse model of myocardial ischemia-reperfusion can be improved by using electrocardiography to validate ligation and reperfusion during surgery and to predict the severity of infarction.     

Reduction of tissue noradrenaline content in the isolated perfused rat heart during ischemia: importance of monoamine oxidation.

The effect of ischemia on myocardial noradrenaline concentration and endogenous noradrenaline output was studied in the isolated perfused rat heart. Following a 15-min stabilization period, regional ischemia was produced by coronary artery ligation. After 60 min of ischemia, noradrenaline concentrations were significantly reduced in the interventricular septum and left ventricle but not in the right ventricle. The reduction in tissue noradrenaline concentration was not prevented when the 60-min ischemia was replaced by a 10-min ischemia followed by a 50-min perfusion. No modification in noradrenaline output was observed during a 60-min ischemia. In contrast, reperfusion was accompanied by a washout of noradrenaline in the coronary effluent, corresponding to only 2% of the amount lost by the tissue. The effect of monoamine oxidase inhibition during the whole ischemic period was studied by perfusing the preparation with pargyline starting 10 min before the artery ligation. Although the administration of pargyline did not alter the noradrenaline output, it did prevent a reduction in myocardial noradrenaline concentration. It was concluded that monoamine oxidase may contribute to the elimination of the noradrenaline lost by the cardiac tissue during ischemia.     

Function of human intrinsic cardiac neurons in situ

We sought to determine the behavior of intrinsic cardiac neurons in human subjects undergoing cardiac surgery and to correlate their activity with hemodynamics status. A lead II electrocardiogram, pulmonary artery pressure, and systemic arterial pressure were recorded along with extracellular activity generated by right atrial neurons in 10 patients undergoing coronary artery bypass surgery. Identified neurons generated spontaneously activity that was, for the most part, unrelated to the cardiac cycle. Most neurons were activated by gentle mechanical distortion of ventricular epicardial loci. The activity generated by neurons in each patient increased when arterial pressure increased and decreased when arterial pressure fell. Intrinsic cardiac neurons continued to generate activity during cardioplegia and cardiopulmonary bypass, but at reduced levels. Normal neuronal activity was restored postbypass. It is concluded that human intrinsic cardiac neurons generate spontaneous activity and that many receive inputs from ventricular mechanosensory neurites. The latter may account for the fact that their behavior depends, in part, on cardiac dynamics. They are also sensitive to intravenously administered pharmacological agents. These data also indicate that cardiopulmonary bypass and cardioplegia do not induce residual depression of their function.     

Characteristics of the energy of electrostatic interaction of the formed elements of blood in experimental myocardial ischemia]

The diffusion and z-potentials of red cells of the blood outflowing from the zone of myocardial ischemia through the branch of the large cardiac vein were studied during acute period of experimental myocardial infarction. This enabled one to calculate the energy of electrostatic repulsion (EER) between blood constituents and to identify the factors exerting a significant effect on this value in acute experimental myocardial infarction induced in 20 dogs by ligation of the anterior interventricular branch of the left coronary artery. It was shown that the energetic state of the double electric lesion is the leading factor in the changed EER and in manifestation of the aggregation activity by the blood constituents. It was noted that the energetic potentials of red cells of the blood collected from the zone of myocardial ischemia show a statistically significant reduction.     

beta1-Adrenoreceptor activation contributes to ischemia-reperfusion damage as well as playing a role in ischemic preconditioning

Protein kinase A (PKA) activation has been implicated in early-phase ischemic preconditioning. We recently found that during ischemia PKA activation causes inactivation of cytochrome-c oxidase (CcO) and contributes to myocardial damage due to ischemia-reperfusion. It may be that beta-adrenergic stimulation during ischemia via endogenous catecholamine release activates PKA. Thus beta-adrenergic stimulation may mediate both myocardial protection and damage during ischemia. The present studies were designed to determine the role of the beta(1)-adrenergic receptor (beta(1)-AR) in myocardial ischemic damage and ischemic preconditioning. Langendorff-perfused rabbit hearts underwent 30-min ischemia by anterior coronary artery ligation followed by 2-h reperfusion. Occlusion-reperfusion damage was evaluated by delineating the nonperfused volume of myocardium at risk and volume of myocardial necrosis after 2-h reperfusion. In some hearts ischemic preconditioning was accomplished by two 5-min episodes of global low-flow ischemia separated by 10 min before coronary occlusion-reperfusion. Orthogonal electrocardiograms were recorded, and coronary flow was monitored by a drip count. Three hearts from each experimental group were used to determine mitochondrial CcO and aconitase activities. Two-hour reperfusion after occlusion caused an additional decrease in CcO activity vs. that after 30-min occlusion alone. Blocking the beta(1)-AR during occlusion-reperfusion reversed CcO activity depression and preserved myocardium at risk for necrosis. Similarly, mitochondrial aconitase activity exhibited a parallel response after occlusion-reperfusion as well as for the other interventions. Furthermore, classic ischemic preconditioning had no effect on CcO depression. However, blocking the beta(1)-AR during preconditioning eliminated the cardioprotection. If the beta(1)-AR was blocked after preconditioning, the myocardium was preserved. Interestingly, in both of the latter cases the depression in CcO activity was reversed. Thus the beta(1)-AR plays a dual role in myocardial ischemic damage. Our findings may lead to therapeutic strategies for preserving myocardium at risk for infarction, especially in coronary reperfusion intervention.     

Nerve Growth Factor Decreases in Sympathetic and Sensory Nerves of Rats with Chronic Heart Failure

Nerve growth factor (NGF) plays a critical role in the maintenance and survival of both sympathetic and sensory nerves. Also, NGF can regulate receptor expression and neuronal activity in the sympathetic and sensory neurons. Abnormalities in NGF regulation are observed in patients and animals with heart failure (HF). Nevertheless, the effects of chronic HF on the levels of NGF within the sympathetic and sensory nerves are not known. Thus, the ELISA method was used to assess the levels of NGF in the stellate ganglion (SG) and dorsal root ganglion (DRG) neurons of control rats and rats with chronic HF induced by myocardial infarction. Our data show for the first time that the levels of NGF were significantly decreased (P < 0.05) in the SG and DRG neurons 6–20 weeks after ligation of the coronary artery. In addition, a close relation was observed between the NGF levels and the left ventricular function. In conclusion, chronic HF impairs the expression of NGF in the sympathetic and sensory nerves. Given that sensory afferent nerves are engaged in the sympathetic nervous responses to somatic stimulation (i.e. muscle activity during exercise) via a reflex mechanism, our data indicate that NGF is likely responsible for the development of muscle reflex-mediated abnormal sympathetic responsiveness observed in chronic HF.     

Retrograde coronary venous perfusion at low pressure

The effectiveness of localized retrograde coronary venous perfusion (RCVP) in preventing or reversing myocardial ischemia after acute ligation of a coronary artery is described. Ten domestic pigs (Group I) underwent aorto left anterior coronary vein grafting with RCVP at systemic pressure. In another set of ten pigs (Group II), the coronary vein was similarly grafted, but the proximal end of the graft was perfused with oxygenated blood by means of an external pump at reduced pressure and flow. In both groups, RCVP successfully reversed the mechanical or electrical effects produced by 2 to 5 minutes of acute arterial ligation. After several hours, Group I animals showed evidence of acute ischemia and developing infarction. Group II animals, however, were maintained for 7 hours or more with regional RCVP and no evidence of ischemia. Retrograde coronary venous perfusion at reduced pressure may be more effective than perfusion at systemic pressure in providing myocardial blood flow.     

Changes in the myocardial ultrastructure of the perfused rabbit heart under hypoxia

Ultrastructure of rabbit heart left ventricle isolated according to Langendorf was examined under different conditions: in intact animals, during ligation of the coronary artery, and hypoxic heart perfusion. The intact perfused heart showed unmarked exo- and intracellular edema and moderate swelling of the mitochondria. During hypoxic perfusion, marked swelling and destruction of the mitochondria were noted. During ligation of the coronary artery, the heart was characterized by a high degree of mitochondrial heterogenicity. The correlation of the data obtained allowed one to reveal the myocardial adaptive-accommodative mechanism, (intermittent mitochondrial activity) that makes it possible to maintain the heart bioenergetics during coronary artery occlusion at a permanently high level.     

白鲜皮水提物对大鼠心肌缺血再灌注损伤的保护作用

目的研究白鲜皮水提物对大鼠心肌缺血再灌注损伤的保护作用。方法 Wistar大鼠随机分为假手术组,模型组,阳性药组(地奥心血康)及白鲜皮低、中、高剂量组(白鲜皮水提物0.128、0.64、1.28 g/kg),每组6只。结扎冠状动脉左前降支制备大鼠心肌缺血再灌注损伤模型,观察给药后大鼠心电图ST段的改变,测量心肌梗死面积,观察大鼠心肌组织病理形态,检测大鼠血清CK,SOD活性、MDA含量。结果白鲜皮中、高剂量组给药后能明显减少心肌梗死面积,明显降低缺血30 min和再灌注120 min时ST段的抬高,并能降低大鼠血清中MDA含量,升高SOD活性,减少因缺血导致的心肌组织病理损害。结论白鲜皮水提物对大鼠心肌缺血再灌注损伤具有保护作用,其作用机制可能与保护心肌细胞功能、提高心肌抗氧化能力、清除氧自由基有关。     

Permanent Ligation of the Left Anterior Descending Coronary Artery in Mice: A Model of Post-myocardial Infarction Remodelling and Heart Failure

Heart failure is a syndrome in which the heart fails to pump blood at a rate commensurate with cellular oxygen requirements at rest or during stress. It is characterized by fluid retention, shortness of breath, and fatigue, in particular on exertion. Heart failure is a growing public health problem, the leading cause of hospitalization, and a major cause of mortality. Ischemic heart disease is the main cause of heart failure.Ventricular remodelling refers to changes in structure, size, and shape of the left ventricle. This architectural remodelling of the left ventricle is induced by injury (e.g., myocardial infarction), by pressure overload (e.g., systemic arterial hypertension or aortic stenosis), or by volume overload. Since ventricular remodelling affects wall stress, it has a profound impact on cardiac function and on the development of heart failure. A model of permanent ligation of the left anterior descending coronary artery in mice is used to investigate ventricular remodelling and cardiac function post-myocardial infarction. This model is fundamentally different in terms of objectives and pathophysiological relevance compared to the model of transient ligation of the left anterior descending coronary artery. In this latter model of ischemia/reperfusion injury, the initial extent of the infarct may be modulated by factors that affect myocardial salvage following reperfusion. In contrast, the infarct area at 24 hr after permanent ligation of the left anterior descending coronary artery is fixed. Cardiac function in this model will be affected by 1) the process of infarct expansion, infarct healing, and scar formation; and 2) the concomitant development of left ventricular dilatation, cardiac hypertrophy, and ventricular remodelling.Besides the model of permanent ligation of the left anterior descending coronary artery, the technique of invasive hemodynamic measurements in mice is presented in detail.     

Membrane alterations in acute myocardial ischemia

The molecular consequences of acute myocardial ischemia induced in rabbit hearts by ligation of the left circumflex branch of the coronary artery were assessed in terms of the biochemical properties of subcellular organelles. Mitochondrial alteration, as reflected in progressive decrease in the activity of azide-sensitive ATPase, was apparent as early as 5 min postligation, but the activity of another mitochondrial enzyme, cytochrome c oxidase, was unchanged, even following 60 min of coronary ligation. Sarcolemmal Na+K+-ATPase exhibited a time course of inactivation similar to that of the mitochondrial ATPase, but differed from the latter in that the impairment was not reversed on reperfusion. Cellular levels of ATP, which decreased in parallel with the loss of ATPase activities, also remained depressed following reperfusion. Decreases in lysosomal enzyme latency were noted, but these occurred somewhat later than the sarcolemmal and mitochondrial alterations. Attempts to demonstrate the production of a population of labile lysosomal structures during ischemia were unsuccessful. Similarly, no alterations in the gel electrophoretic profiles of proteins or in the P phosphatidylcholine/P phosphatidylethanolamine ratio of isolated mitochondrial or sarcolemmal membranes from hearts subjected to ischemia and (or) subsequent reperfusion could be found. It is suggested that sarcolemmal Na+,K+-ATPase may serve as a sensitive and readily quantifiable index of irreversible cellular necrosis and, therefore, be of value in assessing the possible beneficial effects of pharmacological interventions.     

电突触电流在单个吸气性气管运动神经元中的选择性显示

在呼吸相关神经元或其它任何类型的神经元中,与生理性自发活动相对应的电突触电流（gap junction currents,GJCs）尚未在单个神经元中被记录到,因此电突触如何参与呼吸相关的或其它类型的生理性活动,目前所知甚少。在本研究中,我们假设GJCs可在电压钳记录条件下通过消除跨膜电化学梯度在单个神经元实现选择性记录,并在单个吸气性气管迷走神经节前神经元（inspiratory tracheal preganglionic vagal motor neurons,I-TPVMs）进行验证。结果显示,用这种方法在所有I-TPVMs中均记录到GJCs,且这些神经元的GJCs可被节律性中枢吸气活动所激活。此法可用于快速探测具自发活动的神经元网络中的GJCs。     

Activity of in situ middle cervical ganglion neurons in dogs, using extracellular recording techniques

Neuronal activity in the in situ middle cervical ganglion of dogs was investigated using extracellular recording techniques. The recorded action potentials were frequently active during specific phases of the cardiac cycle, particularly during systole, and this activity persisted following acute decentralization of the ganglion. The activity of these action potentials was modified when systemic arterial pressure was altered by isoproterenol, noradrenaline, adrenaline, or partial occlusion of the aorta, whether in the intact or acutely decentralized preparation. These neurons were active between systolic pressures of 70 and 180 mmHg (1 mmHg = 133.322 Pa). Action potentials were frequently modified by mechanical distortion of the superior vena cava, ventricular epicardium, or adventitia of the aorta, whether the preparation was acutely decentralized or not. Seventy percent of these action potentials were unaffected by stimulation (1 ms, 4 V, 0.5 Hz) of a cardiopulmonary nerve and 27% were suppressed by such stimulation. Five of the neurons were activated by such stimulation. It is presumed that the latter neurons had axons in a cardiopulmonary nerve and most likely were efferent sympathetic postganglionic neurons. Sixty-three percent of these spontaneously active phase-locked units were modified by stimulation of a ramus or an ansa. It is postulated that some of the neurons in the middle cervical ganglia can be modified by afferent axons arising from receptors in thoracic organs, in particular from the great vessels and heart, whether in an intact or acutely decentralized preparation. The majority of these neurons are presumed not to be afferent neurons or efferent postganglionic neurons, as they are not activated directly by electrical stimulation of axons in cardiopulmonary nerves. Rather they are presumed to be interneurons. These results lend support to the thesis that considerable integration of neuronal activity related to thoracic cardiovascular dynamics occurs within the middle cervical ganglia of dogs.     

Progressive epicardial coronary blood flow reduction fails to produce ST-segment depression at normal heart rates

ST-segment depression is commonly seen in patients with acute coronary syndromes. Most authors have attributed it to transient reductions in coronary blood flow due to nonocclusive thrombus formation on a disrupted atherosclerotic plaque and dynamic focal vasospasm at the site of coronary artery stenosis. However, ST-segment depression was never reproduced in classic animal models of coronary stenosis without the presence of tachycardia. We hypothesized that ST-segment depression occurring during acute coronary syndromes is not entirely explained by changes in epicardial coronary artery resistance and thus evaluated the effect of a slow, progressive epicardial coronary artery occlusion on the ECG and regional myocardial blood flow in anesthetized pigs. Slow, progressive occlusion over 72 min (SD 27) of the left anterior descending coronary artery in 20 anesthetized pigs led to a 90% decrease in coronary blood flow and the development of ST-segment elevation associated with homogeneous and transmural myocardial blood flow reductions, confirmed by microspheres and myocardial contrast echocardiography. ST-segment depression was not observed in any ECG lead before the development of ST-segment elevation. At normal heart rates, progressive epicardial stenosis of a coronary artery results in myocardial ischemia associated with homogeneous, transmural reduction in regional myocardial blood flow and ST-segment elevation, without preceding ST-segment depression. Thus, in coronary syndromes with ST-segment depression and predominant subendocardial ischemia, factors other than mere increases in epicardial coronary resistance must be invoked to explain the heterogeneous parietal distribution of flow and associated ECG changes.