Epicardial sites for vagal mediation of sinoatrial function

1992 ◽  
Vol 262 (5) ◽  
pp. H1401-H1406 ◽  
Author(s):  
J. D. Mick ◽  
R. D. Wurster ◽  
M. Duff ◽  
M. Weber ◽  
W. C. Randall ◽  
...  
Keyword(s):  
Discharge Rate ◽  
Vena Cava ◽  
Electrical Current ◽  
Retrograde Transport ◽  
Right Atrial ◽  
Bipolar Electrode ◽  
Fat Pad ◽  
Neuronal Marker ◽  
Parasympathetic Ganglia ◽  
Series Of Experiments

The posterior atrial fat pad (PAFP) has been described as the probable anatomic location of parasympathetic ganglia mediating sinoatrial (SAN) and atrioventricular nodal function in the mammalian heart. This contrasts with recent localizations of such control elements in the pulmonary vein fat pad (PVFP) and in fatty tissues overlying the junction of inferior vena cava-inferior left atrium (IVC-ILA), respectively. Short bursts (5-8 pulses/burst, 3 bursts/train) of electrical current (1-16 Hz, 400 ms, 1-5 mA) applied directly to the ventral right atrial epicardium via a concentric bipolar electrode (separation 0.3-0.6 mm) during the atrial muscle refractory period, activated subepicardial postganglionic pathways from PVFP and entering the SAN; identical stimulation of dorsal right atrial epicardium between PAFP and SAN excited few or no fiber pathways controlling SAN discharge rate or patterns. In a second series of experiments, injection of a neuronal marker (Fast Blue) into and around SAN, with time (5-10 days) allowed for retrograde transport, resulted in staining of many soma in PVFP but none in IVC-ILA or PAFP. These data strongly affirm the primary, and perhaps exclusive, localization of ganglia that mediate parasympathetic regulation of SAN function in PVFP of the dog's heart, with little or no such participation by ganglia within PAFP or IVC-ILA.

Inotropic, chronotropic, and dromotropic effects mediated via parasympathetic ganglia in the dog heart

2000 ◽  
Vol 279 (3) ◽  
pp. H1201-H1207 ◽  
Author(s):  
Masato Tsuboi ◽  
Yasuyuki Furukawa ◽  
Koichi Nakajima ◽  
Fumio Kurogouchi ◽  
Shigetoshi Chiba
Keyword(s):  
Superior Vena ◽  
Vena Cava ◽  
Contractile Force ◽  
Right Atrial ◽  
Fat Pad ◽  
Parasympathetic Ganglia ◽  
Dog Heart ◽  
Parasympathetic Nerves ◽  
Av Conduction ◽  
Stimulation Of

Some parasympathetic ganglionic cells are located in the epicardial fat pad between the medial superior vena cava and the aortic root (SVC-Ao fat pad) of the dog. We investigated whether the ganglionic cells in the SVC-Ao fat pad control the right atrial contractile force, sinus cycle length (SCL), and atrioventricular (AV) conduction in the autonomically decentralized heart of the anesthetized dog. Stimulation of both sides of the cervical vagal complexes (CVS) decreased right atrial contractile force, increased SCL, and prolonged AV interval. Stimulation of the rate-related parasympathetic nerves to the sinoatrial (SA) node (SAPS) increased SCL and decreased atrial contractile force. Stimulation of the AV conduction-related parasympathetic nerves to the AV node prolonged AV interval. Trimethaphan, a ganglionic nicotinic receptor blocker, injected into the SVC-Ao fat pad attenuated the negative inotropic, chronotropic, and dromotropic responses to CVS by 33∼37%. On the other hand, lidocaine, a sodium channel blocker, injected into the SVC-Ao fat pad almost totally inhibited the inotropic and chronotropic responses to CVS and partly inhibited the dromotropic one. Lidocaine or trimethaphan injected into the SAPS locus abolished the inotropic responses to SAPS, but it partly attenuated those to CVS, although these treatments abolished the chronotropic responses to SAPS or CVS. These results suggest that parasympathetic ganglionic cells in the SVC-Ao fat pad, differing from those in SA and AV fat pads, nonselectively control the atrial contractile force, SCL, and AV conduction partially in the dog heart.

Separate parasympathetic control of heart rate and atrioventricular conduction of dogs

1990 ◽  
Vol 259 (2) ◽  
pp. H536-H542 ◽  
Author(s):  
D. W. Wallick ◽  
P. J. Martin
Keyword(s):  
Vena Cava ◽  
Atrioventricular Conduction ◽  
Conduction Time ◽  
Fat Pad ◽  
Av Node ◽  
Parasympathetic Ganglia ◽  
Anesthetized Dogs ◽  
Parasympathetic Control ◽  
The Right ◽  
Electrical Stimuli

In open-chest, autonomically decentralized, anesthetized dogs, a brief burst of electrical stimuli was delivered at various time delays to the right pulmonary vein (RPV) fat pad. This fat pad contains parasympathetic ganglia that innervate the sinoatrial (SA) node. Each burst elicited a bimodal increase in the cardiac cycle length (CCL) without eliciting a significant change in atrioventricular conduction time (AVCT). A similar burst was applied to the inferior vena cava-inferior left atrial fat pad. This fat pad contains nerves that innervate the AV node. This latter stimulation elicited a bimodal increase in AVCT without eliciting any change in the CCL. When the cervical vagi were stimulated in a similar manner, a bimodal increase in the CCL was elicited that was similar to the response we observed when the RPV fat pad was stimulated. In contrast, the dromotropic response was quite variable. In conclusion, we could, for the most part, elicit selective parasympathetic control of either the SA or the AV node, respectively.

Single-Patch Fold-Back Technique for Augmentation of the Superior Vena Cava in Sinus Venosus Atrial Septal Defect Associated with Partial Anomalous Pulmonary Venous Return

2015 ◽  
Vol 17 (6) ◽  
pp. 282
Author(s):  
Suguru Ohira ◽  
Kiyoshi Doi ◽  
Takeshi Nakamura ◽  
Hitoshi Yaku
Keyword(s):  
Atrial Septal Defect ◽  
Superior Vena Cava ◽  
Septal Defect ◽  
Venous Return ◽  
Superior Vena ◽  
Pulmonary Veins ◽  
Vena Cava ◽  
Sinus Venosus ◽  
Right Atrial ◽  
Anomalous Pulmonary Venous Return

Sinus venosus atrial septal defect (ASD) is usually associated with partial anomalous pulmonary venous return (PAPVR) of the right pulmonary veins to the superior vena cava (SVC), or to the SVC-right atrial junction. Standard procedure for repair of this defect is a patch roofing of the sinus venosus ASD and rerouting of pulmonary veins. However, the presence of SVC stenosis is a complication of this technique, and SVC augmentation is necessary in some cases. We present a simple technique for concomitant closure of sinus venosus ASD associated with PAPVR and augmentation of the SVC with a single autologous pericardial patch.

scholarly journals Cardiac effects of activation of the parasympathetic ganglia in the third fat pad in dog hearts.

1999 ◽  
Vol 79 ◽  
pp. 100
Author(s):  
Tsuboi Masato ◽  
Furukawa Yasuyuki ◽  
Koichi Nakajima ◽  
Fumio Kurogouchi ◽  
Chiba Shigetoshi
Keyword(s):  
Fat Pad ◽  
Cardiac Effects ◽  
Parasympathetic Ganglia ◽  
The Third

scholarly journals Use of ultrasound-measured internal jugular vein collapsibility index to determine static intracardiac pressures in patients with presumed pulmonary hypertension

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Raj Parikh ◽  
Matthew Spring ◽  
Janice Weinberg ◽  
Christine C. Reardon ◽  
Harrison W. Farber
Keyword(s):  
Pulmonary Hypertension ◽  
Internal Jugular Vein ◽  
Jugular Vein ◽  
Vena Cava ◽  
Right Atrial ◽  
Volume Status ◽  
Manual Compression ◽  
Respiratory Variation ◽  
Fluid Status ◽  
Collapsibility Index

Abstract Background Bedside ultrasound helps to estimate volume status in critically ill patients and has traditionally relied on diameter, respiratory variation, and collapsibility of the inferior vena cava (IVC) to reflect fluid status. We evaluated collapsibility of the internal jugular vein (IJ) with ultrasound and correlated it with concomitant right heart catheterization (RHC) measurements in patients with presumed pulmonary hypertension. Methods and results We studied 71 patients undergoing RHC for evaluation of pulmonary hypertension. Using two-dimensional ultrasound (Sonosite, Washington, USA), we measured the diameter of the IJ at rest, during respiratory variation, and during manual compression. Collapsibility index during respiration (respiratory CI) and during manual compression (compression CI) was calculated. We correlated mean right atrial pressure (mRAP) and pulmonary artery occlusion pressure (PAOP) defined by RHC measurements with respiratory and compression CI. A secondary goal was examining correlations between CI calculations and B-type natriuretic peptide (BNP) levels. Baseline characteristics demonstrated female predominance (n = 51; 71.8%), mean age 59.5 years, and BMI 27.3. There were significant correlations between decrease in compression CI and increase in both mRAP (Spearman: − 0.43; p value = 0.0002) and PAOP (Spearman: − 0.35; p value = 0.0027). In contrast, there was no significant correlation between respiratory CI and either mRAP (Spearman: − 0.14; p value = 0.35) or PAOP (Spearman:− 0.12; p value = 0.31). We also observed significant negative correlation between compression CI and BNP (Spearman: − 0.31; p value = 0.01) but not between respiratory CI and BNP (Spearman: − 0.12; p value = 0.35). Conclusion Increasing use of ultrasound has led to innovative techniques for estimating volume status. While prior ultrasound studies have used clinical parameters to estimate fluid status, our study used RHC measurements and demonstrated that compression CI potentially reflects directly measured mRAP and PAOP.

scholarly journals Obstruction of the inferior vena cava following bicaval orthotopic heart transplantation: a case series

2021 ◽  
Vol 5 (2) ◽  
Author(s):  
Anas Abudan ◽  
Brent Kidd ◽  
Peter Hild ◽  
Bhanu Gupta
Keyword(s):  
Inferior Vena Cava ◽  
Heart Transplantation ◽  
Inferior Vena ◽  
Rare Complication ◽  
Vena Cava ◽  
Case Series ◽  
Transoesophageal Echocardiography ◽  
Right Atrial ◽  
Orthotopic Heart Transplantation ◽  
Eustachian Valve

Abstract Background Inferior vena cava (IVC) obstruction is a rare complication of orthotopic heart transplantation (OHT) and is unique to bicaval surgical technique. The clinical significance, diagnosis, complications, and management of post-operative IVC anastomotic obstruction have not been adequately described. Case summary Two patients with end-stage heart failure presented for bicaval OHT. Post-operative course was complicated with shock refractory to fluid resuscitation and inotropic/vasopressor support. Obstruction at the IVC-right atrial (RA) anastomosis was diagnosed on transoesophageal echocardiography (TOE), prompting emergent reoperation. In both cases, a large donor Eustachian valve was found to be restricting flow across the IVC-RA anastomosis. Resection of the valve resulted in relief of obstruction across the anastomosis and subsequent improvement in haemodynamics and clinical outcome. Discussion Presumably rare, we present two cases of IVC obstruction post-bicaval OHT. Inferior vena cava obstruction is an under-recognized cause of refractory hypotension and shock in the post-operative setting. Prompt recognition using TOE is crucial for immediate surgical correction and prevention of multi-organ failure. Obstruction can be caused by a thickened Eustachian valve caught in the suture line at the IVC anastomosis, which would require surgical resection.

scholarly journals Isolated Marked Inferior Vena Cava Dilatation: Unusual Presentation or Underrecognized Common Phenomenon?

2018 ◽  
Vol 2018 ◽  
pp. 1-3 ◽  
Author(s):  
Sneha R. Gadi ◽  
Benjamin K. Ruth ◽  
Alan Johnson ◽  
Sula Mazimba ◽  
Younghoon Kwon
Keyword(s):  
Inferior Vena Cava ◽  
Inferior Vena ◽  
Vena Cava ◽  
Unusual Presentation ◽  
Atrial Pressure ◽  
Right Atrial ◽  
Right Atrial Pressure ◽  
Common Phenomenon ◽  
Right Heart

Inferior vena cava (IVC) diameter and respirophasic variation are commonly used echocardiographic indices to estimate right atrial pressure. While dilatation of the IVC and reduced collapsibility have traditionally been associated with elevated right heart filling pressures, the significance of isolated IVC dilatation in the absence of raised filling pressures remains poorly understood. We present a case of an asymptomatic 28-year-old male incidentally found to have IVC dilatation, reduced inspiratory collapse, and normal right heart pressures.

Increased cardiac output following occlusion of the descending thoracic aorta in dogs

1982 ◽  
Vol 243 (1) ◽  
pp. R152-R158 ◽  
Author(s):  
J. K. Stene ◽  
B. Burns ◽  
S. Permutt ◽  
P. Caldini ◽  
M. Shanoff
Keyword(s):  
Cardiac Output ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Thoracic Aorta ◽  
Vascular System ◽  
Superior Vena ◽  
Vena Cava ◽  
Right Atrial ◽  
Mean Systemic Pressure ◽  
Extracorporeal Bypass

Occlusion of the thoracic aorta (AO) in dogs with a constant volume right ventricular extracorporeal bypass increased cardiac output (Q) by 43% and mean arterial pressure by 46%, while mean systemic pressure (MSP) was unchanged. We compared AO with occlusion of the brachiocephalic and left subclavian arteries (BSO) which decreased cardiac output by 5%, increased mean arterial pressure by 32%, and increased MSP by 11%. We feel these results confirm that AO elevates preload by transferring blood volume from the splanchnic veins to the vascular system drained by the superior vena cava. If the heart is competent to keep right arterial pressure at or near zero, this increase in preload will elevate Q above control levels. Comparing our data with results of other authors who have not controlled right atrial pressure, emphasizes the importance of a competent right ventricle in allowing venous return to determine Q.

Influence of right atrial stretch on plasma renin activity in the conscious rat

1987 ◽  
Vol 65 (2) ◽  
pp. 257-259 ◽  
Author(s):  
Susan Kaufman
Keyword(s):  
Plasma Renin Activity ◽  
Superior Vena ◽  
Vena Cava ◽  
Extracellular Fluid ◽  
Plasma Renin ◽  
Renin Activity ◽  
Right Atrial ◽  
Balloon Inflation ◽  
Conscious Rat ◽  
Basal Plasma

Rats were prepared with inflatable balloons at the superior vena cava – right atrium junction. After recovery 1 week later, when blood was taken from conscious, normovolaemic animals plasma renin activity was found not to be influenced by right atrial stretch. Plasma renin activity was then measured in rats in which an extracellular fluid deficit had been produced by peritoneal dialysis against a hyperoncotic, isotonic solution. Although basal plasma renin activity was elevated (6.8 ± 0.9 from 1.5 ± 0.2 ng∙mL∙h, n = 19), no depression was observed in the experimental group after 15 or 90 min of balloon inflation. In rats pretreated with isoprenaline (10 μg/kg body wt.) plasma renin activity was also increased over basal levels, but again balloon inflation caused no reduction in plasma renin activity. It would appear that right atrial stretch has little, if any, influence on renin release in the conscious rat.

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