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[Methods of investigating the heart conduction system].

A description is presented of improved methods of examining the conductive system of the heart designed for special routine investigations. The methodology comprises: a) injection of coronary arteries with contrast medium and their X-ray visualization, b) special technique of heart postmortem, c) histological investigation with a view to the precise topography of the particular parts of the conductive system including detailed histological processing in series cestions by means of staining methods: haematoxylin-eosin, elastica-van Gieson, P. A. S., and Heidenhain.

Coronary Angiography

[Cellular architecture of the sheep myocardium and heart conduction system as revealed with silver-impregnation method].

Morphological studies were carried out to delineate the cellular architecture of the myocardium and heart conduction system in adult sheep using the silver-impregnation method. Reticular fibers were heavily stained in a deep black color, while collagen fibers were less intensely silver-stained in a brownish color. Individual working myocardial cells were ensheathed by thin reticular fibers and showed a polygonal form, and were connected with adjacent cells mainly end-to-end and sometimes side-to-side. Thick collagen septa were distributed between masses of myocardial cells. The nodal cells in both the sinoatrial (SA) node and atrioventricular (AV) node were spindle shaped, smaller in size than myocardial cells, and surrounded by thin reticular fibers. The bundles of SA node cells were linearly oriented, while those of AV node cells formed a reticular pattern. The cells in the His bundle and Purkinje system were oval in shape, larger in size than myocardial cells and formed the strands composed of 4-8 cells. Each stand was surrounded by thick reticular fibers. These cells had both end-to-end and side-to-side contacts. Purkinje cells were followed by transitional cells which were in contact with myocardial cells. On the other hand, the reticular fibers and collagen fibers showed characteristic structures at the different portion of heart. The present study discusses the topographical relationship between cardiac muscle cells containing the conduction system and the connective tissue sheaths surrounding muscle cells.

Animals

[Characteristics of the status of autonomic innervation and of the functioning of the heart conduction system in alcoholism].

As many as 71 men fit for work (aged 32.6 years on the average) suffering from stage II alcoholism were examined with the aid of variation pulsimetry. The findings obtained were compared with the data of electrophysiological exploration of the heart by transesophageal pacing. In the majority of the patients (80.2% of cases), the changes in vegetative homeostasis manifested themselves primarily by activation of the sympathetic nervous system and combined both with a noticeable decrease of sinus node automatism function and an appreciable deterioration of conduction in the sinoatrial zone and atrioventricular junction. In addition, sinus node automatism function and sinoatrial conduction were inhibited to a greater degree in sympatheticotonia whereas deterioration of antegrade impulse conduction in the atrioventricular junction manifested itself mostly in association with predominant vagus influences. It is emphasized that in patients with alcoholism, sympatheticotonia was attended by different impairments of the heart rhythm in half of the cases.

Adolescent

Cytoskeletal filaments of heart conducting system localized by antibody against a 55,000 dalton protein.

Cow heart conducting cells characteristically contain cytoplasmic intermediate-sized filaments. We report here the preparation of a specific antibody to a 55,000 dalton protein of isolated cow Purkinje fibres. Confirmation has been obtained that these filaments consist of the 55,000 dalton protein, using the indirect immunofluorescence technique. Cross-reaction is seen with vascular endothelium and smooth muscle cells of various origin, suggesting close identity of different types of intermediate-sized filaments.

Animals

[Evaluation of the heart conduction system in patients with ventricular allorhythmia].

Intracardiac electrophysiologic studies of the sinus node and conductive system of the heart were carried out in 51 patients with ventricular allorhythmias. In half of the cases, ventricular allorhythmias occurred in patients with impaired sinus node operation and abnormal atrioventricular impulse conduction. It is suggested that anti-arrhythmic drugs associated with adverse chrono- and dromotropic effects should be used with caution.

Adult

[Topography of the elements of the heart conduction system in the human].

In 112 preparations of hearts from persons at the age of 18-87 years by means of the preparation method (77 hearts) and in histograms stained after Van Gieson, Mallory, Heidenhain and Masson (35 hearts), certain new data on the cardiac conduction system (CCS) have been obtained. A number of fasciculi connected with the sinuatrial and atrioventricular nodes have been revealed. The atrioventricular part of the CCS, as a more ancient one, is characterized by a more constant structure and topography. The sinuatrial part of the CCS, being phylogenetically younger, has a high degree of individual anatomical changeability.

Adolescent