Morphology, distribution, and variability of the epicardiac neural ganglionated subplexuses in the human heart

摘要: Concomitant with the development of surgical treatment cardiac arrythmias and management myocardial ischemia, there is renewed interest in morphology intrinsic nervous system. In this study, we analyze topography structure human epicardiac neural plexus (ENP) as a system seven ganglionated subplexuses. The ENP was revealed by histochemical method for acetylcholinesterase whole hearts 21 humans examined stereoscopic, contact, bright-field microscopy. According to criteria established distinguish subplexuses, they are extensions mediastinal nerves entering heart through discrete sites hilum proceeding separately into regions innervation pathways, on courses which ganglia, wide fields, plentifully located. It that subplexuses consistent from heart. general, right atrium innervated two left three, ventricle one, three highest density ganglia identified near hilum, especially dorsal dorsolateral surfaces atrium, where up 50% all were number study ranged 706 1,560 not correlated age most regions. contained average 836 +/- 76 ganglia. structural organization within observed vary considerably relation age. neurons any ganglion significantly fewer aged compared infants. By estimating relating epicardium, it calculated approximately 43,000 might be present adult 94,000 young (fetuses, neonates, children). conclusion, demonstrates total using staining acetylcholinesterase, provides morphological framework an understanding how structurally organized