BACKGROUND: Atrial fibrillation (AF) is the most common arrhythmia and despite obvious clinical importance remains its pathogenesis only partially explained. A relation between inflammation and AF has been suggested by findings of increased inflammatory markers in AF patients. OBJECTIVE: The goal of this study was to characterize morphologically and functionally CD45-positive inflammatory cell populations in atrial myocardium of patients with AF as compared to sinus rhythm (SR). METHODS: We examined 46 subjects (19 with AF, and 27 in SR) undergoing coronary bypass or valve surgery. Peroperative bioptic samples of the left and the right atrial tissue were examined using immunohistochemistry. RESULTS: The number of CD3+ T-lymphocytes and CD68-KP1+ cells were elevated in the left atrial myocardium of patients with AF compared to those in SR. Immune cell infiltration of LA was related to the rhythm, but not to age, body size, LA size, mitral regurgitation grade, type of surgery, systemic markers of inflammation or presence of diabetes or hypertension. Most of CD68-KP1+ cells corresponded to dendritic cell population based on their morphology and immunoreactivity for DC-SIGN. The numbers of mast cells and CD20+ B-lymphocytes did not differ between AF and SR patients. No foci of inflammation were detected in any sample. CONCLUSIONS: An immunohistochemical analysis of samples from patients undergoing open heart surgery showed moderate and site-specific increase of inflammatory cells in the atrial myocardium of patients with AF compared to those in SR, with prevailing population of monocyte-macrophage lineage. These cells and their cytokine products may play a role in atrial remodeling and AF persistence.
- MeSH
- B-lymfocyty imunologie patologie MeSH
- fibrilace síní imunologie patologie patofyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mastocyty imunologie patologie MeSH
- myokard imunologie patologie MeSH
- počet buněk MeSH
- senioři MeSH
- sinusová arytmie imunologie patologie patofyziologie MeSH
- srdeční síně imunologie patologie patofyziologie MeSH
- T-lymfocyty imunologie patologie MeSH
- tvar buňky MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
The aim of this study was to ascertain the persistence of heart rate and blood pressure oscillations at the onset of voluntary apnea in humans and to assess the dependence of the fluctuations parameters on the chemoreceptor activity. In 24 young subjects (10 males, 14 females, mean age 20.4 years) heart rate (represented by its reciprocal value--RR-intervals), systolic blood pressure (SBP) and diastolic blood pressure (DBP) during controlled breathing (CB) of atmospheric air and oxygen followed by apnea were recorded continuously. The cosine functions were then fitted by nonlinear regression analysis to the heart rate, SBP and DBP oscillations during CB and at the onset of apnea. The parameters of oscillations were different during atmospheric air breathing compared to oxygen breathing. During oxygen breathing there was an increase of the RR-interval oscillations--relative bradycardia and enhanced magnitude of respiratory sinus arythmia. During apnea, the base level of the blood pressure oscillations was higher after breathing of atmospheric air compared to oxygen breathing. At least one cosine-like wave oscillation was present at the onset of apnea in the heart rate, SBP and DBP and the second wave was present in all assessed parameters in at least 70% of recordings. The oscillations in RR-intervals are, to some extent, independent of blood pressure oscillations. No significant gender differences were found either in the duration of breath holding or in the RR and SBP oscillations parameters.
- MeSH
- apnoe patofyziologie MeSH
- dospělí MeSH
- dýchání MeSH
- krevní tlak fyziologie MeSH
- kyslík aplikace a dávkování MeSH
- lidé MeSH
- mladiství MeSH
- periodicita * MeSH
- reflex fyziologie MeSH
- sinusová arytmie patofyziologie MeSH
- srdeční frekvence fyziologie MeSH
- vůle fyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- kyslík MeSH
The cold pressor test is used in the clinical testing of the autonomic nervous system. However, little is known about changes in the autonomic control of the cardiovascular system during repeated challenge with cold. Heart rate (HR), respiratory sinus arrhythmia (RSA), T-wave amplitude of ECG (TWA), blood pressure, body temperature and perceived pain were recorded in 18 male subjects during three CPTs which consisted of four minutes immersion of the left hand into cold water at 1 degree C. Breathing during CPT was either spontaneous or paced at 0.23 Hz or 0.1 Hz. Pain intensity and HR decreased and TWA increased during the cold immersion and in the resting period preceding cold in the second and third trials. Systolic and pulse blood pressure increased in resting periods in the third trial. RSA increased in the second and third cold challenge during paced breathing at 0.1 Hz only. A decrease in body temperature (0.48 degree C) at the end of the experiment correlated marginally with HR changes. Our study shows that sustained cardiovascular changes are induced by the first challenge with cold, and persist or increase with repeated cold pressor tests.
- MeSH
- analýza rozptylu MeSH
- autonomní nervový systém fyziologie MeSH
- dospělí MeSH
- elektrokardiografie MeSH
- kardiovaskulární systém inervace MeSH
- krevní tlak fyziologie MeSH
- lidé MeSH
- měření bolesti MeSH
- nízká teplota MeSH
- pulz fyziologie MeSH
- referenční hodnoty MeSH
- sinusová arytmie patofyziologie MeSH
- srdeční frekvence fyziologie MeSH
- termoregulace fyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- klinické zkoušky MeSH
- srovnávací studie MeSH
Patterns of arterial supply to the atria were studied with respect to the coronary sinus region in 60 human hearts obtained from patients with a negative cardiac history and in 2 hearts with ECG-demonstrated coronary sinus rhythm. The atria, including the interatrial septum, were supplied by the right (40%) or left (30%) or both (30%) sinuatrial arteries which, however, did not reach as far as the posterior margin of the oval fossa and the coronary sinus. The region of the coronary sinus with the Eustachian ridge received direct branches from the trunk of the right (41%) or left (11%) coronary artery or both (48%) in the adjacent part of the coronary sulcus. Possible development of the 'coronary sinus rhythm' on the basis of multifocal damage of the sinuatrial arteries is discussed.
- MeSH
- koronární cévy anatomie a histologie patofyziologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- senioři MeSH
- sinusová arytmie patologie patofyziologie MeSH
- srdeční frekvence MeSH
- vény anatomie a histologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- kazuistiky MeSH
Based on clinical and experimental experience, pacemaker dysfunction in sick sinus syndrome can be differentiated into intrinsic and extrinsic. Sinus node activity is characterized electrophysiologically by automaticity, recovery and sinoatrial conduction. The automaticity of the sinus pacemaker cell groups and sinus recovery can be differentiated properly under experimental conditions. Studies of the electrophysiological characteristics have shown the basic functional parameters to be normal in extrinsic-autonomic sinus dysfunction. Diagnosis is either based on clinical observation or on the data of Holter monitoring, the electrophysiological methods being inadequate for diagnosing this neurovegetative form of sick sinus syndrome. On the other hand, intrinsic sinus dysfunction can be diagnosed by electrophysiological tests. If completed by complex pharmacological studies, in this organic form of sick sinus syndrome, even the severity of the intrinsic injuries can be assessed quantitatively. The above division provides a basis for selection and evaluation of the differential diagnostic procedures, while information on the aetiopathology of sinus dysfunction and on the degree of the functional injuries of the electrophysiological structure of the heart provides an adequate basis for therapy.
- MeSH
- autonomní nervový systém patofyziologie MeSH
- bradykardie diagnóza patofyziologie MeSH
- diferenciální diagnóza MeSH
- dospělí MeSH
- elektrokardiografie * MeSH
- lidé středního věku MeSH
- lidé MeSH
- monitorování fyziologických funkcí MeSH
- nodus sinuatrialis patofyziologie MeSH
- sinoatriální blokáda diagnóza patofyziologie MeSH
- sinusová arytmie diagnóza patofyziologie MeSH
- srdeční blokáda diagnóza MeSH
- syndrom chorého sinu diagnóza patofyziologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- MeSH
- bradykardie etiologie patofyziologie MeSH
- elektrická stimulace MeSH
- elektrokardiografie MeSH
- lidé středního věku MeSH
- lidé MeSH
- nodus sinuatrialis patofyziologie MeSH
- senioři MeSH
- sinusová arytmie etiologie patofyziologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- MeSH
- atropin MeSH
- časové faktory MeSH
- dítě MeSH
- dospělí MeSH
- kojenec MeSH
- lidé MeSH
- mladiství MeSH
- nodus sinuatrialis patofyziologie MeSH
- předškolní dítě MeSH
- sinoatriální blokáda diagnóza MeSH
- sinusová arytmie patofyziologie MeSH
- srdeční arytmie patofyziologie MeSH
- Check Tag
- dítě MeSH
- dospělí MeSH
- kojenec MeSH
- lidé MeSH
- mladiství MeSH
- mužské pohlaví MeSH
- předškolní dítě MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Názvy látek
- atropin MeSH
- MeSH
- elektrokardiografie MeSH
- funkční vyšetření srdce * MeSH
- lidé MeSH
- minutový srdeční výdej MeSH
- nemoci srdce patofyziologie MeSH
- nodus sinuatrialis fyziologie MeSH
- počítače MeSH
- postura těla MeSH
- sinusová arytmie patofyziologie MeSH
- spektrální analýza MeSH
- srdeční frekvence MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
The influence of retrograde conduction of the artificial pacemaker impulse from the right ventricle to the atria exerted upon the occurrence of rapid supraventricular rythms was investigated in patients with sick sinus syndrome. The bouts of tachycardia occurred in cases with fixed V-A retrograde block or coincided with temporary V-A block. The usually operating retrograde conduction from the pacemaker to the atria protects the patients from paroxysms of supraventricular tachycardia by means of the coordinated depolarization of the atria and junctional tissue.
- MeSH
- bradykardie patofyziologie MeSH
- elektrokardiografie MeSH
- kardiostimulace umělá * MeSH
- lidé MeSH
- převodní systém srdeční patofyziologie MeSH
- sinusová arytmie patofyziologie MeSH
- srdeční komory patofyziologie MeSH
- srdeční síně patofyziologie MeSH
- tachykardie patofyziologie MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
