论文标题
心房中机械电耦合途径的调查
A Survey of Pathways for Mechano-Electric Coupling in the Atria
论文作者
论文摘要
尽管慢性心房扩张与心房颤动(AF)之间存在着众所周知的关联,但迄今为止,心房组织中的机械电耦合(MEC)仍接受了稀疏研究。值得注意的是,在文献中已经确定了与拉伸激活的通道,细胞电容和几何效应有关的六种不同机制。在这篇微型审查中,我们将这些途径中的每一种简要调查到MEC。然后,我们在存在各种拉伸方案和MEC途径的情况下使用单细胞和组织模型进行计算模拟。这使我们能够评估每种途径在确定动作电位持续时间,传导速度和转子稳定性方面的相对重要性。对于慢性心房拉伸,我们发现膜电容的拉伸诱导的改变会降低传导速度并增加动作潜在持续时间,这与实验发现一致。在时间依赖性的被动心房拉伸的情况下,拉伸激活的通道起着最大的作用,导致peLARIVATION和ROTOR超级弥补。这些发现表明,生理心房伸展,例如心房储层阶段的被动拉伸,可能在心房心律失常发生的机制中起重要作用。
Mechano-electric coupling (MEC) in atrial tissue has received sparse investigation to date, despite the well-known association between chronic atrial dilation and atrial fibrillation (AF). Of note, no fewer than six different mechanisms pertaining to stretch-activated channels, cellular capacitance and geometric effects have been identified in the literature as potential players. In this mini review, we briefly survey each of these pathways to MEC. We then perform computational simulations using single cell and tissue models in presence of various stretch regimes and MEC pathways. This allows us to assess the relative significance of each pathway in determining action potential duration, conduction velocity and rotor stability. For chronic atrial stretch, we find that stretch-induced alterations in membrane capacitance decrease conduction velocity and increase action potential duration, in agreement with experimental findings. In the presence of time-dependent passive atrial stretch, stretch-activated channels play the largest role, leading to after-depolarizations and rotor hypermeandering. These findings suggest that physiological atrial stretches, such as passive stretch during the atrial reservoir phase, may play an important part in the mechanisms of atrial arrhythmogenesis.