Ardell J L, Andresen M C, Armour J A, Billman G E, Chen P-S, Foreman R D, Herring N, O'Leary D S, Sabbah H N, Schultz H D, Sunagawa K, Zucker I H
University of California - Los Angeles (UCLA) Cardiac Arrhythmia Center, David Geffen School of Medicine, Los Angeles, CA, USA.
UCLA Neurocardiology Research Center of Excellence, David Geffen School of Medicine, Los Angeles, CA, USA.
J Physiol. 2016 Jul 15;594(14):3877-909. doi: 10.1113/JP271869. Epub 2016 Jun 17.
Neuronal elements distributed throughout the cardiac nervous system, from the level of the insular cortex to the intrinsic cardiac nervous system, are in constant communication with one another to ensure that cardiac output matches the dynamic process of regional blood flow demand. Neural elements in their various 'levels' become differentially recruited in the transduction of sensory inputs arising from the heart, major vessels, other visceral organs and somatic structures to optimize neuronal coordination of regional cardiac function. This White Paper will review the relevant aspects of the structural and functional organization for autonomic control of the heart in normal conditions, how these systems remodel/adapt during cardiac disease, and finally how such knowledge can be leveraged in the evolving realm of autonomic regulation therapy for cardiac therapeutics.
从岛叶皮质水平到心脏固有神经系统,分布于整个心脏神经系统的神经元成分相互之间持续进行交流,以确保心输出量与局部血流需求的动态过程相匹配。在将源自心脏、大血管、其他内脏器官和躯体结构的感觉输入进行转导的过程中,不同“水平”的神经元成分会以不同方式被募集,以优化局部心脏功能的神经元协调。本白皮书将综述正常情况下心脏自主控制的结构和功能组织的相关方面、这些系统在心脏病期间如何重塑/适应,以及最后如何在不断发展的心脏治疗自主调节治疗领域利用这些知识。