ISSN:1045-3873    

DOI:10.1111/j.1540-8167.1991.tb01359.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

ISSN:1045-3873    

DOI:10.1111/j.1540-8167.1991.tb01705.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Cardiovascular and Pain Regulatory Systems.Several recent findings provide evidence that cardiovascular and pain regulatory systems are interactive. The physiological responses to acute pain are discussed and hypothetical organizational models that explain how cardiovascular and pain regulatory systems interact are proposed. The adaptive value of interactions between cardiovascular and pain regulatory systems is discussed. It is proposed that maladaptive cardiovascular‐somatosensory interactions may contribute to several cardiovascular disorders such as essential hypertension, asymptomatic myocardial ischemia, and life‐threatening cardiac arrhythm

ISSN:1045-3873    

DOI:10.1111/j.1540-8167.1991.tb01366.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Cross‐over infusions of quinidine (Q) and hydrvcjuinidine (HQ) ivere perfonned at 8‐day intenmls in 12 pentobarhital‐anesthetized dogs. Three increasing doses were administered each time and the mean plasma concentrations (mg/L) were 2.8, 3.7, and 4.9 with Q and 1.2, 1.9, and 2.8 with HQ. Four electrophysiological studies were perfonned at baseline and after each dose. Both drugs exhibited Class IA effects without qualitative differences: sinus automaticiti/ and nodal conduction parameters were increased only Zi'ith the highest doses of drugs; His Purkinje (HV) and intraventricular (QRS) conduction times were increased consistently but only slightly and, for example, mean values of HV increased from 28 to 33 msec after Q and 30 to 34 msec after HQ. The largest increases were seen for QT interval (227 to 294 msec after Q and 237 to 292 msec after HQ), ventricular effective refractory periods (158 to 182 msec after Q and 161 to 185 msec after HQ), and atrial refractory periods (124 to 178 msec after Q and 120 to 172 msec after HQ). For the later parameter, hydroquinidine appeared significantly more potent with a potenaj ratio relative to quinidine estimated at 1.9 and 2.9 respectively for effective and functional atrial refractory periods. If confirmed, this higher potency of hydroquinidine versus quinidine should be clinicalli/ considered, for example, during drug plasma levels monit

ISSN:1045-3873    

DOI:10.1111/j.1540-8167.1991.tb01707.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Suspension of Neural Pathways for Pain and Nociception.This review traces the changing conceptualization of the biological mechanisms underlying pain sensation from the time of Descartes. The anatomical basis for the existence of a system dedicated to pain is discussed in the light of detailed neuroanatomical knowledge developed during the past quarter century. The adequacy of defining pain in terms of noxious stimulation is questioned. Instead, pain sensation might better be understood in the context of somatovisceral function, with its underlying neuroanatomical complexity and dynamic interactions between ascending and descending systems.

ISSN:1045-3873    

DOI:10.1111/j.1540-8167.1991.tb01363.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Associated Inhibition of Sympathetic and Afferent Activities.In intact animals, it is important that most “tonic” sympathetic activity be regulated by brainstem systems that have access to “central commands” from higher centers and to highly specific cranial nerve afferents. The importance of this supraspinal regulation is manifested by severe derangements of sympathetic regulation after spinal cord injury. A major component of these derangements is an exaggerated responsiveness of sympathetic neurons to visceral and somatic afferent activity. Although much is known about medullo‐spinal systems that excite sympathetic preganglionic neurons, little is known about those systems that, in intact animals, isolate preganglionic neurons from spinal afferent input. This brief review will consider the evidence that either identical or cospatial medullary systems regulate the output of sympathetic preganglionic neurons and afferent input to the spinal cord. Further, evidence from this laboratory is presented, which indicates that a recently described system in the rostral cervical spinal cord, perhaps in concert with medullary systems, may play an important role in regulating the excitation of sympathetic preganglionic neurons by spinal

ISSN:1045-3873    

DOI:10.1111/j.1540-8167.1991.tb01364.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Intravenous flecainide (1.5 mg/kg) was given to 30 patients with acute supraventricular tachyarrhythmias: atrial fibrillation (12 patients), atrial flutter (7 patients), and reciprocating tachycardia due to reentry through an accessory pathway (5 patients). The total rate of conversion to sinus rhythm was 18 out of 30 patients (60%), 11 out of 11 patients (100%) with reciprocating tachycardia and 7 out of 19 patients (37%) with atrial flutter or fibrillation. In those patients not converted to sinus rhythm, the mean ventricular rate significantly (P<0.1) slowed from 140 ± 15 beats/min with slowing of ventricular rate below 100 beats/min in 2 patients. Tolerable side effects occurred in 5 patients (17%) and included transient moderate hypotension (1 patient), blurred vision (1 patient), and transient conduction defects (3 patients). We conclude that intravenous flecainide is a safe and effective antiarrhythmic agent for the termination of acute reciprocating tachycardias and moderately useful for the management of atrial flutter or fibrillation

ISSN:1045-3873    

DOI:10.1111/j.1540-8167.1991.tb01708.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

We performed programmed ventricular stimulation on 69 patients with left ventricular ejection dysfunction (ejection fraction6 beats ventricular tachycardia) was found in 74% of patients. Patients with clinically sustained arrhythmias were frequently inducible (89%) with a high incidence of inducible monomorphic ventricular tachycardia (82%). Patients with clinically nonsustained ventricular tachycardia had a lower rate of inducibility (63%) including a high incidence of inducible polymorphic ventricular tachycardia (27%). Inducible patients with left ventricular dysfunction and ventricular tachycardia had a low incidence of electrophysiologically demonstrated effective drug therapy (16%). However, if an effective drug was found, the prognosis was good. Empirical drug therapy was associated with a poor prognosis in inducible and noninducible patients. Finally, an unfavorable prognosis was associated with a clinically sustained arrhythmia, a lower ejection fraction, and the presence of a left ventricular aneurysm. An inducible arrhythmia did not predict an unfavorable course. Indeed, patients with noninducible ventricular tachycardia in this group of patients were still at risk for sudden cardiac death.

ISSN:1045-3873    

DOI:10.1111/j.1540-8167.1991.tb01709.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

ISSN:1045-3873    

DOI:10.1111/j.1540-8167.1984.tb01641.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY

摘要:

Spinal Pathways for Somatocardiac Reflexes.Small, somatic afferent fibers, among which mediate painful responses, have important influences on the functions of the heart and vasculature by reflexly controlling autonomic nervous system activity. These reflexes are largely conducted by ascending spinal pathways to the brainstem. The spinal pathways mediating somatosympathetic reflexes are reviewed and compared to those involved in somatovagal reflexes controlling the heart. In seven chloralose anesthetized cats, single unit activity was recorded from cardiac vagal preganglionic fibers. Supramaximal, electrical stimulation of the peroneal nerve inhibited the excitatory influences from electrical stimulation of the carotid sinus nerve. From spinal lesion studies, these inhibitory influences are conducted through ascending, bilateral, spinal pathways in the dorsolateral sulcus area near the dorsal root entry zone. Following these lesions, peroneal nerve stimulation produces vagoexcitatory responses. Thus, similar to reflex effects on sympathetic activity to the heart and vasculature, somatic afferents can excite or inhibit vagal control of the heart, although the directional changes are the reciprocal to those of the sympathetic responses. These somatoautonomic reflex responses involve pathways that ascend in the dorsolateral funiculus and sulcus areas of the cat spinal cord.

ISSN:1045-3873    

DOI:10.1111/j.1540-8167.1991.tb01365.x

出版商:Blackwell Publishing Ltd    

年代:1991

数据来源: WILEY