unilateral vagotomy

单侧迷走神经切断术
  • 文章类型: Journal Article
    背景:急性单侧损伤对心脏水平的两个迷走神经自发电活动的影响知之甚少。我们通过记录每个心脏迷走神经(VN)的尖峰活动,研究了右或左心脏迷走神经横断(VNTx)后的即时神经电反应。
    方法:14只雄性哥廷根小型猪进行了胸骨切开术。在心电图和血流动力学监测期间,在切口水平以下植入多电极袖带以记录迷走神经电图信号,心脏VNTx之前和之后立即(左:L-cut,n=6;右:R-cut,n=8)。
    结果:左心脏VNTx显着降低了迷走神经残端的多单位电活动(MUA)放电率(-30.7%vs预切割)和完整的右VN(-21.8%vs预切割)在心脏水平,在不影响心率的情况下,心率变异性,或者血液动力学.相比之下,右心VNTx在任一VN中均未显著改变MUA,但连续RR间期差异(rMSSD)的均方根略有增加(p<0.022),副交感神经流出指数,而不影响血液动力学。
    结论:我们的研究揭示了单侧心脏迷走神经切断术后迷走神经尖峰活动的早期左外侧化模式。这些发现增强了对迷走神经损伤的神经电反应的理解,并为单侧心脏迷走神经切断术后保留迷走神经流出提供了见解。重要的是,监测心脏右VN的尖峰活动可以预测左迷走神经通路损伤的发作,这对心脏病患者有害,并且可能作为心房颤动导管消融的并发症发生。
    BACKGROUND: The impact of acute unilateral injury on spontaneous electrical activity in both vagus nerves at the heart level is poorly understood. We investigated the immediate neuroelectrical response after right or left cardiac vagal nerve transection (VNTx) by recording spiking activity of each heart vagus nerve (VN).
    METHODS: Fourteen male Göttingen minipigs underwent sternotomy. Multi-electrode cuffs were implanted below the cut level to record vagal electroneurographic signals during electrocardiographic and hemodynamic monitoring, before and immediately after cardiac VNTx (left: L-cut, n = 6; right: R-cut, n = 8).
    RESULTS: Left cardiac VNTx significantly reduced multi-unit electrical activity (MUA) firing rate in the vagal stump (-30.7% vs pre-cut) and intact right VN (-21.8% vs pre-cut) at the heart level, without affecting heart rate, heart rate variability, or hemodynamics. In contrast, right cardiac VNTx did not acutely alter MUA in either VN but slightly increased (p < 0.022) the root mean square of successive RR interval differences (rMSSD), an index of parasympathetic outflow, without affecting hemodynamics.
    CONCLUSIONS: Our study reveals an early left-lateralized pattern in vagal spiking activity following unilateral cardiac vagotomy. These findings enhance understanding of the neuroelectrical response to vagal injury and provide insights into preserving vagal outflow after unilateral cardiac vagotomy. Importantly, monitoring spiking activity of the cardiac right VN may predict onset of left vagal pathway injury, which is detrimental to cardiac patients and can occur as a complication of catheter ablation for atrial fibrillation.
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  • 文章类型: Journal Article
    心脏去神经支配在许多患者中是一个严重的问题,包括心脏移植后的患者。穿过迷走神经节前纤维后副交感神经节的状态尚未得到足够的研究。我们研究的目的是评估体能训练对大鼠右侧和左侧迷走神经切断术后副交感神经心房神经节形态参数和心率自主神经调节的影响。在一项包括对心率变异性进行三次评估的研究后,使用免疫组织化学方法评估了右心房神经节的形态测量特征。发现右侧迷走神经切断术会导致神经节体积增加和自主神经功能障碍。在体能训练后保持节前神经支配的同时,假和左侧迷走神经切断术的动物中,神经细胞数量没有发现明显变化。而运动导致右侧神经支配大鼠的神经组织体积减少。还发现,在迷走神经支配得到保留的动物中,心房神经节组织的体积与总体心率变异性和正常的副交感神经成分相关。因此,只有保留节前迷走神经的影响,规律的体力活动对副交感神经调节的积极作用才是可以预期的。
    Cardiac denervation is a serious problem in a number of patients, including patients after heart transplantation. The status of the parasympathetic ganglia after crossing the preganglionic fibers of the vagus nerve has not been enough studied. The aim of our study was to assess the effect of physical training on the morphological parameters of the parasympathetic atrial ganglia and autonomic regulation of heart rate after right- and left-sided vagotomy in rats. Morphometric characteristics of the right atrial ganglia were evaluated using an immunohistochemical method after a study that included a three-time assessment of heart rate variability. It was found that right-sided vagotomy leads to both an increase in the volume of ganglion and autonomic dysfunction. No significant change in the number of nerve cells was found in animals with false and left-sided vagotomy while maintaining preganglionic innervation after the physical training, whereas exercises led to a decrease in the volume of nerve tissue of rats with right-sided denervation. It was also found that in animals with preserved vagal innervation, the volume of atrial ganglion tissue correlates with overall heart rate variability and a normalized parasympathetic component. Therefore, a positive effect from regular physical activity on parasympathetic regulation can be expected only if preganglionic vagal influence is preserved.
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  • 文章类型: Comparative Study
    OBJECTIVE: We aimed to evaluate the effects of unilateral vagotomy (right-VR or left-VL) on the severity of caerulein-induced acute pancreatitis (AP).
    METHODS: VR or VL was done in Wistar rats 4 days before AP, except in control, sham operated group. Following 5 h administration of subcutaneous injections of caerulein, the pancreatic blood flow (PBF), serum lipase and IL-10 in caval blood samples were measured. The pancreatic specimens were taken from sacrificed rats for the assessment of MDA-4-HNE and morphology.
    RESULTS: PBF decreased from 310 ± 20 ml/min/100 g of tissue in control rats to 130 ± 12 units in AP (p < 0.01). VR and VL alleviated this effect to 234 ± 22 and 229 ± 26 units, respectively, (p < 0.01). There was an immense increase of serum lipase in AP, from 100 ± 7 U/L up to 5220 ± 210 U/L (p < 0.01). Only VL limited this increase to 3469 ± 300 U/L (p < 0.01). Serum IL-10 increased uniformly in AP, without any effect of preceding VR or VL. VL performed in rats subjected subsequently to AP resulted in stronger reduction of histological changes, such as pancreatic edema and leukocyte infiltration, than the above parameters in AP rats with VR. MDA+4-HNE increased from 7.5 ± 0.1 pmol/g of tissue in control group to 30.6 ± 3 units in AP group (p < 0.01). Concentration of MDA+4-HNE in pancreatic tissue achieved 16.48 ± 3 pmol/g after VR and 13.84 ± 4 pmol/g following VL.
    CONCLUSIONS: Our observation might suggest that protective effect of VL could be stronger than VR in the protection on AP. However changes of PBF seem to be similar in both groups of rats.
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  • 文章类型: Journal Article
    Unilateral cooling of the vagus nerve (<5°C, blocking mainly conductivity of myelinated fibers) and unilateral vagotomy were employed to reduce cough afferent drive in order to evaluate the effects of these interventions on the temporal features of the cough reflex. Twenty pentobarbitone anesthetized, spontaneously breathing cats were used. Cough was induced by mechanical stimulation of the tracheobronchial airways. The number of coughs during vagal cooling was significantly decreased (p<0.001). Inspiratory cough efforts were reduced by approximately 30% (p<0.001) and expiratory motor drive by more than 80% (p<0.001). Temporal analysis showed prolonged inspiratory and expiratory phases, the total cycle duration, its active portion, and the interval between maxima of the diaphragm and the abdominal activity during coughing (p<0.001). There was no significant difference in the average effects on the cough reflex between cooling of the left or the right vagus nerve. Compared to control, vagal cooling produced no significant difference in heart rate and mean arterial blood pressure (p>0.05), however, cold block of vagal conduction reduced respiratory rate (p<0.001). Unilateral vagotomy significantly reduced cough number, cough-related diaphragmatic activity, and relative values of maximum expiratory esophageal pressure (all p<0.05). Our results indicate that reduced cough afferent drive (lower responsiveness) markedly attenuates the motor drive to respiratory pump muscles during coughing and alters cough temporal features. Differences in the effects of unilateral vagal cooling and vagotomy on coughing support an inhibitory role of sensory afferents that are relatively unaffected by cooling of the vagus nerve to 5°C on mechanically induced cough.
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