Biomedical subjects

H F Downey

Publications and source records attributed to H F Downey.

At least 37 records · Page 2Linked to original sources

PubMed1996

Endogenous adenosine increases O2 utilisation efficiency in isoprenaline-stimulated canine myocardium.

OBJECTIVE: We have previously demonstrated that myocardium is capable of down-regulating its O2 requirements and thus avoiding ischaemia when O2 supply is limited. The present study tested the hypothesis that endogenous adenosine produced this protective response when O2 supply was decreased by moderate coronary hypoperfusion or moderate coronary hypoxaemia. METHODS: In anaesthetised dogs, hearts were exposed by left thoracotomy and instrumented for measuring intraventricular pressure and regional myocardial segment length. The left anterior descending coronary artery was isolated, cannulated, and extracorporeally perfused. Coronary O2 supply was moderately reduced by lowering coronary perfusion pressure from 100 to 60 mmHg or by lowering coronary arterial O2 content by 50%. Hearts were treated with intracoronary infusions of adenosine, adenosine deaminase to degrade endogenous adenosine or with erythro-9-(2-hydroxy-3-nonyl)-adenine x HCl (EHNA) to inhibit adenosine degradation by endogenous adenosine deaminase, during beta-adrenergic stimulation with isoprenaline. Cardiac power in the left anterior descending perfusion territory was indexed by the product of heart rate x left ventricular peak systolic pressure x percent systolic segment shortening. O2 utilisation efficiency was taken as the ratio of power index/myocardial O2 consumption. RESULTS: Prior to a reduction in O2 supply, isoprenaline did not alter O2 utilisation efficiency. Intracoronary adenosine increased O2 utilisation efficiency during isoprenaline stimulation by 23% (P < 0.05). EHNA slightly increased O2 utilisation efficiency during isoprenaline stimulation (10%; P < 0.05); adenosine deaminase was without effect. When coronary perfusion pressure was decreased, adenosine deaminase sharply lowered cardiac power and O2 utilisation efficiency during isoprenaline stimulation, whereas EHNA augmented isoprenaline-enhanced power and increased efficiency. During hypoxaemia, adenosine deaminase lowered regional power but not efficiency during isoprenaline infusion; EHNA did not affect power but lowered O2 consumption and increased efficiency. Myocardial lactate extraction and contractile function during isoprenaline stimulation were not attenuated by reduced O2 supply, indicating that myocardial ischaemia did not occur under these conditions. CONCLUSION: Endogenous adenosine increases myocardial O2 utilisation efficiency during beta-adrenergic stimulation, and thus helps avert ischaemia when myocardial O2 supply is reduced.

Adenine↗

PubMed1995

Does interstitial adenosine mediate acute hibernation of guinea pig myocardium?

OBJECTIVE: The aim was to test the role of interstitial adenosine in protective downregulation of myocardial energy demand during myocardial hibernation. METHODS: Isolated working guinea pig hearts, perfused with glucose fortified Krebs-Henseleit, were subjected to 60 min global low flow ischaemia followed by 30 min reperfusion. Left ventricular performance was assessed from heart rate-developed pressure product and pressure-volume work. Cytosolic energy level was indexed by creatine phosphate and ATP phosphorylation potentials measured in snap frozen myocardium. Lactate and purine nucleosides (adenosine, inosine) were measured in venous effluent. RESULTS: When coronary flow was lowered by 80% for 60 min, heart rate-pressure product and pressure-volume work fell 87% and 75%, respectively, and stabilised at these low levels, but fully recovered when flow was restored. Myocardial ATP phosphorylation potential fell by 67% during the first 10 min of ischaemia, but subsequently recovered to preischaemic levels despite continuing ischaemia, indicating down-regulation of myocardial energy demand. Lactate release increased about 10-fold during ischaemia and remained increased until reperfusion. Purine nucleoside release varied reciprocally with phosphorylation potential, peaking at 10 min of ischaemia, then gradually returning to the preischaemic level during the subsequent 50 min of ischaemia. The ecto 5'-nucleotidase inhibitor alpha,beta-methylene adenosine 5'-diphosphonate (50 microM) decreased ischaemic purine nucleoside release by 41%, but did not attenuate postischaemic contractile recovery. The unspecific adenosine receptor antagonist 8-p-sulphophenyl theophylline (8-SPT, 20 microM) doubled ischaemic lactate release and lowered coronary venous purine nucleoside release by 21%. 8-SPT increased phosphorylation potential at 10 min ischaemia relative to untreated hearts, but blunted the subsequent rebound of phosphorylation potential. 8-SPT treatment during ischaemia resulted in a significantly higher cytosolic phosphorylation potential at 30 min of reperfusion, but did not affect postischaemic contractile function. CONCLUSIONS: We conclude that activation of adenosine receptors results in recovery of cytosolic energy level of moderately ischaemic working myocardium, but this energetic recovery is not solely responsible for postischaemic contractile recovery.

5'-Nucleotidase↗

PubMed1994

Coronary perfusion related changes in myocardial contractile force and systolic ventricular stiffness.

OBJECTIVE: The mechanism by which changes in coronary perfusion alter myocardial oxygen consumption (MVO2; Gregg phenomenon) is controversial. This study examined the effect of coronary perfusion on myocardial contractile force and systolic ventricular stiffness in the intact, ejecting heart. METHODS: During selective perfusion of the left anterior descending coronary artery, coronary blood flow was changed with or without concurrent changes in coronary perfusion pressure in 19 alpha chloralose anaesthetised dogs. Regional myocardial segment length (end diastolic length; end systolic length) and developed force were measured with piezoelectric crystals and with a miniature force transducer, respectively. MVO2 was calculated from coronary flow and arteriovenous O2 difference. The slope of the force-length curve during ejection period (delta F/delta SL) was used as an index of systolic myocardial stiffness. RESULTS: When coronary perfusion pressure was varied from 60 to 180 mm Hg (protocol 1, n = 11), maximum developed force (Fmax), delta F/delta SL, and MVO2 increased with perfusion pressure while end diastolic length, segmental shortening, and other haemodynamic variables stayed constant. When coronary blood flow was increased at constant perfusion pressure by infusion of either a low dose or a high dose adenosine (protocol 2, n = 8), Fmax, delta F/delta SL, and MVO2 increased while end diastolic length, segmental shortening, and other haemodynamic variables stayed constant. MVO2 and delta F/delta SL increased more steeply with flow in protocol 1. CONCLUSIONS: (1) Increased coronary blood flow enhances myocardial contractile force, systolic ventricular stiffness, and MVO2 in the intact, ejecting heart. (2) Coronary blood flow induced changes in myocardial contractile force and systolic ventricular stiffness, but not end diastolic length, are probably responsible for coronary blood flow related changes in MVO2.

Adenosine↗

PubMed1994

Coronary pressure-flow autoregulation protects myocardium from pressure-induced changes in oxygen consumption.

Pressure-flow autoregulation minimizes changes in coronary blood flow (CBF) when coronary perfusion pressure (CPP) is altered. This investigation determined if autoregulation also minimizes CPP-induced changes in coronary vascular volume (CVV) and CVV-dependent changes in myocardial oxygen consumption (MVO2). In 11 anesthetized dogs, the left anterior descending coronary artery was cannulated, and responses to 20-mmHg changes in CPP were examined over a range of CPP from 60 to 180 mmHg. Changes in CPP had no significant effect on systemic hemodynamics or on left ventricular end-diastolic segment length, end-systolic segment length, or percent segment shortening. In hearts with effective pressure-flow autoregulation [closed-loop gain (GC) > 0.4], CVV increased 0.06%/mmHg change in CPP. For the same hearts, MVO2 increased 0.04%/mmHg change in CPP. In hearts with ineffective autoregulation (GC < 0.4), CVV increased 0.97%/mmHg (P < 0.001 vs. autoregulating hearts), and MVO2 increased 0.41%/mmHg (P < 0.001 vs. autoregulating hearts). MVO2 and CVV were correlated (r = 0.69, P < 0.0001) independently of autoregulatory capability, but only when autoregulation was poor and capacitance was elevated did CPP significantly affect MVO2. We conclude that pressure-flow autoregulation protects myocardium from CPP-induced changes in CVV, which in turn produces changes in oxygen consumption.

Analysis of Variance↗

PubMed1993

Effects of snuff on regional blood flow to the cheek and tongue of anesthetized dogs.

Regional blood flow to the cheek and tongue of anesthetized dogs was measured before and after application of six different doses of snuff (3.12 to 100 mg/kg body weight) to the right cheek. Dose-independent vasodilation was observed at the site of application, whereas dose-dependent vasoconstriction was observed contralaterally. Aortic, central venous, and ventricular pressures were significantly increased (p < 0.05) at the higher doses. Plasma nicotine concentrations increased stepwise with dose.

Analysis of Variance↗

PubMed1993

Preconditioning with supply-demand imbalance limits infarct size in dog heart.

OBJECTIVE: The aim was to examine whether an absolute reduction in energy supply is required for preconditioning against myocardial infarction, and whether an episode of increased adrenergic activity with or without supply-demand imbalance is capable of triggering cardioprotection. METHODS: 41 anaesthetised dogs were subjected to 60 min left circumflex artery occlusion followed by 5 h reperfusion (control group, n = 8). The left stellate cardiac nerve was stimulated for 5 min starting 10 min before coronary occlusion in the stimulation group (STIM group, n = 8). The left circumflex artery flow increase that normally accompanies adrenergic stimulation was prevented by a pneumatic occluder in another group (STIM-R group, n = 8). Infarct size and area at risk were determined by triphenyl tetrazolium chloride staining and Evans blue dye, respectively. Regional myocardial blood flow during ischaemia and during stimulation (STIM-R group) was measured with radioactive microspheres. RESULTS: In the STIM group, adrenergic stimulation increased the coronary blood flow by approximately twofold from baseline. In the STIM-R group, transmural myocardial blood flow in the flow restricted left circumflex artery region was 64% of the flow to the non-flow-restricted left anterior descending coronary artery region. Haemodynamic variables were not different among the experimental groups except during adrenergic stimulation. Collateral blood flow and area at risk were comparable among the three groups. Infarct size as a percentage of area at risk (%IS/AAR) was significantly smaller in the STIM-R group [7.6(3.2)%] than in the control group [27.9(7.3)%], whereas %IS/AAR in the STIM group [21.7(4.1)%] was not. Furthermore, the regression line between collateral blood flow and %IS/AAR was significantly shifted downward in the STIM-R group, but not in the STIM group. CONCLUSIONS: (1) Transient energy supply-demand imbalance triggers infarct size limitation; an absolute reduction in energy supply is not required for preconditioning. (2) Increased adrenergic activity without supply-demand imbalance seems unable to trigger appreciable cardioprotection.

Animals↗

PubMed1993

Hypoxic preconditioning attenuates stunning caused by repeated coronary artery occlusions in dog heart.

OBJECTIVE: The aim was to test whether a brief period of non-ischaemic hypoxia can attenuate cardiac contractile dysfunction, ie, "stunning", due to repeated coronary artery occlusions. METHODS: 20 anaesthetised dogs underwent six 5 min occlusions of the left anterior descending coronary artery with intervening 10 min reperfusions, prior to 90 min reperfusion. In the treated group (n = 9), hearts were preconditioned by 5 min extracorporeal left anterior perfusion with severely hypoxic blood [O2 content 14(SEM 3) ml.litre-1] followed by 10 min reperfusion, prior to the repeated coronary occlusions. Controls (n = 9) were sham preconditioned by 5 min extracorporeal perfusion with normoxic blood [O2 content 179(7) ml.litre-1]. Regional contractile function was assessed by systolic segmental shortening measured by microsonometry. Regional myocardial oxygen consumption, an index of ATP utilisation, was measured in these protocols to evaluate the hypothesis that reduction of myocardial energy demand could be a mechanism of hypoxic preconditioning. RESULTS: Hypoxic preconditioning slightly decreased systolic segmental shortening [64.1(9.5)% of baseline at 10 min reoxygenation v 85.5(6.5)% for control, p < 0.05]. In contrast, 5 min coronary occlusion in controls produced more marked cardiodepression [segmental shortening 33.5(10.1)% of baseline at 10 min reperfusion; p < 0.05 v 10 min reoxygenation in the hypoxic-preconditioned group]. Systolic shortening was preserved in hypoxic-preconditioned hearts as compared to controls during each 10 min reperfusion period. Furthermore, functional recovery at 90 min reperfusion after the last occlusion in hypoxic preconditioned hearts was more complete than in control hearts, at 40.8(13.1)% v -16.1(14.4)%; p < 0.05. However, myocardial oxygen consumption was not suppressed by hypoxic preconditioning. CONCLUSIONS: Five minutes of hypoxic preconditioning attenuated contractile dysfunction due to repeated brief ischaemia/reperfusion stress. This protective effect was not due to the suppression of myocardial energy demand.

Adenosine Triphosphate↗

PubMed1993

Arteriovenous-shunt-mediated increase in venous return causes apparent right coronary arterial autoregulation.

OBJECTIVE: Reports of autoregulation in the right coronary vasculature have varied from non-existent to almost perfect. At least some of this discrepancy may be due to failure to account for changes in myocardial metabolism secondary to the method used to vary perfusion pressure. The aim of this study was to determine if the potent autoregulation reported when right coronary perfusion pressure was lowered by opening a large arteriovenous shunt was due to increased right ventricular myocardial oxygen consumption (MVO2) induced by augmented preload and afterload. METHODS: Two protocols were used to produce right coronary perfusion pressures of 100, 80, and 60 mm Hg in anaesthetised dogs. In both protocols the right coronary artery was cannulated and supplied with blood from a pressurised chamber. In protocol 1, right coronary perfusion pressure was decreased independently of aortic pressure, and in protocol 2, aortic pressure was decreased in parallel with right coronary perfusion pressure by opening a large arteriovenous shunt. Right coronary blood flow, central venous pressure, and pulmonary arterial pressure were measured, and right ventricular oxygen extraction and MVO2. Central venous pressure (right ventricular preload) and pulmonary arterial pressure (right ventricular afterload) did not change. In protocol 2, opening the arteriovenous shunt increased venous return, as shown by increased central venous pressure and pulmonary arterial pressure. This increased right ventricular MVO2 at the lower right coronary perfusion pressures and maintained right coronary blood flow at the level recorded when right coronary perfusion pressure was 100 mm Hg. CONCLUSIONS: This apparently potent autoregulation resulted from the shunt induced increase in oxygen consumption at low right coronary perfusion pressures, in contrast to the decreased right ventricular oxygen consumption and right coronary blood flow observed when right coronary perfusion pressure is selectively decreased.

Animals↗

PubMed1993

Interstitial purine metabolites and lactate during regional myocardial hypoxia.

OBJECTIVE: Adenosine is a well known vasodilator believed to contribute to metabolic adjustments of the coronary circulation. The purpose of this study was to assess changes in interstitial fluid adenosine, adenosine metabolites, and lactate during prolonged regional, non-ischaemic myocardial hypoxia. METHODS: To induce regional hypoxia, the left anterior descending coronary artery of anaesthetised dogs (n = 9) was perfused at constant pressure (100 mm Hg) with deoxygenated blood (PO2 approximately 2.6 kPa) for 60 min via an extracorporeal shunt. Cardiac interstitial fluid was sampled by cardiac microdialysis, using dialysate metabolite levels as indices of interstitial fluid concentrations. RESULTS: During hypoxia, coronary blood flow increased 3.9-fold, while myocardial oxygen consumption was maintained relatively constant. There were no changes in global cardiac function, systemic arterial pressure, or heart rate during regional hypoxia, indicating that the hypoxic stimulus did not augment sympathetic nervous system activity. Dialysate adenosine was not increased at any point of the hypoxic period, but was decreased by 25 min hypoxia. Dialysate levels of inosine, hypoxanthine, and xanthine were increased transiently during the first 10 min of hypoxia while there was a sustained increase in dialysate lactate. In the presence of erythro-9-(2-hydroxy-3-nonyl) adenine, an adenosine deaminase inhibitor, adenosine was the predominant purine metabolite and increased transiently during hypoxia. CONCLUSIONS: Flux through the adenosine production and degradation pathways is transiently increased during hypoxia. However, the lack of an increase in interstitial fluid adenosine does not support a role for adenosine in the sustained hyperaemic response to regional myocardial hypoxia.

Adenosine↗

PubMed1993

Downregulation of oxygen demand in isoprenaline stimulated canine myocardium.

OBJECTIVE: The aim was to evaluate the hypothesis that the oxygen demand of stimulated myocardium is downregulated and ischaemia avoided when oxygen supply is limited. METHODS: Isoprenaline stimulation during reduced coronary perfusion pressure or moderate coronary hypoxaemia was studied in relation to myocardial oxygen demand, power, and oxygen utilisation efficiency (O2Effic) in 19 anaesthetised open chest dogs. The left anterior descending coronary artery was perfused with normoxic blood at 100 or 60 mm Hg or with moderately hypoxic blood [CaO2 = 9.8(SEM 0.2) ml.dl-1] at 100 mm Hg. Myocardial oxygen demand was estimated from oxygen consumption (MVO2), and power index was computed from heart rate, left ventricular pressure, and segment shortening. O2Effic was calculated from power index divided by MVO2. Lactate extraction and contractile function were used as indices of myocardial ischaemia. RESULTS: Isoprenaline under control conditions increased coronary blood flow, MVO2, and power index, but did not alter lactate extraction. Reducing coronary perfusion pressure to 60 mm Hg decreased oxygen delivery by 31.6(5.7)% (p < 0.05). MVO2 fell by 26.6(8.6)% (p < 0.05), but power index and lactate extraction were not reduced. At reduced coronary perfusion pressure, isoprenaline-induced elevation of MVO2 decreased from 26.0(1.5) to 15.7(2.6) ml.min-1 x 100 g-1 (p < 0.05), but the isoprenaline-induced rise in power index was not significantly lessened, nor was lactate extraction altered. O2Effic was increased by reduced coronary perfusion pressure and by isoprenaline during reduced coronary perfusion pressure. Hypoxaemia increased coronary blood flow but did not alter oxygen delivery, MVO2 or power index. Isoprenaline-induced elevation of MVO2 decreased from 25.2(1.7) to 19.1(0.5) ml.min-1 x 100 g-1 (p < 0.05), and power index decreased by 33(9.1)% (p < 0.05). O2Effic was not altered by hypoxaemia or by isoprenaline during hypoxaemia. CONCLUSIONS: Oxygen demand of isoprenaline stimulated myocardium is downregulated and ischaemia is avoided when oxygen is limited. Downregulation of oxygen demand is achieved by increasing oxygen utilisation efficiency in the presence of reduced coronary perfusion pressure and by decreasing power in the presence of hypoxaemia.

Animals↗

PubMed1992

Hypoxic preconditioning of ischaemic canine myocardium.

OBJECTIVE: The aim was to test whether a brief period of non-ischaemic hypoxia can precondition myocardium. METHODS: 60 anaesthetised adult mongrel dogs of either sex underwent 60 min occlusion of the left anterior descending coronary artery, followed by 5 h reperfusion. In treated groups, hearts were either preconditioned with 5 min coronary perfusion with hypoxic blood [O2 content 9.2(SEM 0.6) ml.litre-1] or 5 min occlusion followed by a 10 min reperfusion period prior to 60 min occlusion. The effect of these treatments on myocardial infarct size and regional contractile function was assessed. RESULTS: Infarct size, determined by tetrazolium staining, as a percentage of anatomical area at risk was markedly decreased in hypoxia preconditioned hearts, at 7.2(1.8)% v 22.4(4.6)% in controls (p < 0.01), but did not differ from ischaemia preconditioned hearts [4.6(1.7)%; p < 0.01 v control]. Anatomical area at risk, expressed as a percentage of left ventricular mass, and collateral blood flow to the inner two thirds of the ischaemic wall did not differ among the groups. Regional contractile function was depressed following ischaemic preconditioning but not following hypoxic preconditioning. During reperfusion following 60 min occlusion, marked paradoxical systolic lengthening was evident in ischaemia preconditioned and control hearts but not in hypoxia preconditioned myocardium. CONCLUSIONS: Five minutes of hypoxic and ischaemic preconditioning were equipotent in preventing infarction, whereas ischaemic preconditioning caused a greater decrement in postischaemic contractile function.

Animals↗

PubMed1992

Canine coronary vasodepressor responses to hypoxia are attenuated but not abolished by 8-phenyltheophylline.

The purpose of this study was twofold: 1) to verify a report that a suspension of 8-phenyltheophylline (8-PT) completely abolished hypoxia-induced coronary vasodilation [H. M. Wei, Y. H. Kang, and G. F. Merrill. Am. J. Physiol. 257 (Heart Circ. Physiol. 26): H1043-H1048, 1989] and 2) to determine the effect of dissolved 8-PT on hypoxic hyperemia. The left anterior descending coronary artery of anesthetized dogs was cannulated and perfused at either constant flow or constant pressure. An 8-PT suspension (40 micrograms.kg-1.min-1) produced a twofold elevation of coronary perfusion pressure at constant flow, a 97% decrease in coronary flow at constant pressure, and regional akinesia in both conditions. The coronary vasculature was unresponsive to 60-s coronary occlusion, exogenous adenosine, and hypoxia after infusion of the 8-PT suspension. These findings are consistent with obstruction of the coronary microvasculature by the 8-PT suspension. An 8-PT solution (40 micrograms.kg-1.min-1) produced 95 +/- 3% (P less than 0.001, n = 6) attenuation of exogenous adenosine-induced vasodilation at constant pressure, a 28 +/- 5% (P less than 0.01, n = 6) attenuation of reactive hyperemia, and a 24 +/- 6% (P less than 0.05, n = 6) decrease in hypoxia-induced vasodilation. An 8-PT solution had no effect on systolic segment length shortening and myocardial oxygen consumption. We conclude that 8-PT, when in solution, attenuates but does not abolish the coronary vasodilatory response to hypoxia. Hence, adenosine appears to contribute to hypoxia-induced vasodilation but is not uniquely responsible for the hyperemic response.

Adenosine↗

PubMed1992

Effects of a coronary alpha 1-constriction on transmural left ventricular flow and contractile function.

Modulation of myocardial contractile function and perfusion by alpha 1-adrenergic receptors were examined in anesthetized dogs during left stellate ganglion stimulation. In 11 dogs, stellate stimulation significantly increased heart rate, mean arterial pressure, left ventricular systolic pressure, maximal rate of left ventricular pressure generation, segmental shortening and rate of shortening in anterior and posterior ventricular regions, and myocardial oxygen extraction. Myocardial lactate extraction decreased. The selective alpha 1-adrenergic antagonist prazosin (0.5 mg) injected into the circumflex artery during stellate stimulation caused significant additional increases in maximal rate of left ventricular pressure generation by 19 +/- 5% and in rate of shortening in posterior subendocardium by 20 +/- 6%. No changes were observed in posterior subepicardial or anterior subendocardial segmental contractile function. Myocardial oxygen and lactate extractions returned to their control values following prazosin injection. Regional left ventricular perfusion was measured using tracer microspheres in five additional dogs. Stellate stimulation increased subepicardial and subendocardial perfusion by 30%. Prazosin increased both subepicardial and subendocardial perfusion by an additional 36%. Stellate stimulation increased norepinephrine concentration in the coronary sinus, but no further increase was noted after blockage of alpha 1-receptors by prazosin. Thus, during sympathetic stimulation, an alpha 1-vasoconstriction existed uniformly across the left ventricular wall. However, blockade of this vasoconstriction was associated with an increase in contractile function only in the deeper muscle layers.

Adrenergic alpha-Antagonists↗

PubMed1991

Systemic hypoxia activates a coronary vasoconstrictor reflex response that is blocked by prazosin.

We assessed the presence of an alpha 1-adrenoceptor-mediated coronary vasoconstrictor reflex response during acute systemic hypoxia in eight chloralose-anesthetized dogs. We avoided local vasodilator responses to myocardial and coronary hypoxia and to circulating factors by perfusing the left common coronary artery at constant pressure with normoxic blood while the dogs were ventilated with 5% O2-95% N2. Left ventricular afterload was held constant by withdrawing arterial blood during hypoxia-induced peripheral vasoconstriction. Left ventricular (LV) preload, as indicated by left atrial pressure, was unchanged. beta-adrenoceptor-mediated coronary dilation and positive chronotropic and inotropic responses to hypoxia were blocked by propranolol. Para-sympathetic-mediated coronary dilation and bradycardia were blocked by atropine. Under these conditions, systemic hypoxia caused a 19.7 +/- 2.1% decrease in left common coronary blood flow. Blockade of left coronary alpha 1-adrenoceptors with prazosin prevented coronary vasoconstriction during repeated systemic hypoxia. In four other similarly prepared dogs, repeated systemic hypoxia without alpha 1-adrenoceptor blockade reproducibly reduced left coronary blood flow 16.3 +/- 3.5 and 15.7 +/- 3.1%, respectively. The results of this investigation provide the first evidence of a coronary vasoconstrictor reflex response to systemic hypoxia. This response is mediated by alpha 1-adrenoceptors.

Adrenergic alpha-Antagonists↗

PubMed1990

Adrenal release of catecholamines in the coronary and myocardial response to nicotine.

The role of cardiac neural stimulation in the absence of direct effects of nicotine and other circulating factors was evaluated by perfusing a region of left ventricular myocardium with blood from a reservoir during systemic nicotine infusion. In normally perfused myocardium, contractile function increased, but in reservoir-perfused myocardium, function deteriorated. To evaluate direct effects of nicotine on myocardial contractile function, nicotine was infused directly into a perfused coronary artery. An intracoronary concentration of nicotine equivalent to that caused by intravenous administration (0.69 +/- 0.08 micrograms per ml plasma) had no effect on myocardial contractile function. An intracoronary nicotine concentration of 5 micrograms/ml was required to directly increase contractile function to approximately the same extent observed during intravenous nicotine. To evaluate the role of circulating catecholamines in the myocardial contractile response to intravenous nicotine, observations were made before and after bilateral adrenalectomy. Adrenalectomy markedly attenuated the pressor response to intravenous nicotine and abolished the positive cardiac inotropic response. We conclude that the adrenal release of catecholamines is primarily responsible for increased myocardial contractile function during intravenous nicotine.

Adrenal Glands↗

PubMed1990

Adenosine exacerbates ischemic myocardial injury during regional coronary hypoxemia in the dog.

To investigate the myocardial protective effect of adenosine (ADO), the left anterior descending artery of 10 dogs was cannulated and perfused at a pressure of 100 mmHg. Hypoxic coronary perfusion was conducted for 60 min followed by 60 min of normoxic reperfusion (group 1, control, n = 5). In group 2 (n = 5), ADO was continuously infused at a rate of 40 micrograms/kg/min for 30 min before and during 60 min of hypoxic blood perfusion and for 60 min following normoxic reperfusion. In group 1, R wave amplitude and TQ segment of the epicardial surface electrocardiogram (EPIECG) were reduced, the ST segment was elevated, and a new Q wave developed during hypoxic blood perfusion. However, at 60 min of normoxic reperfusion, the R wave amplitude recovered to approximately 60% of its control value. Also, ST segment elevation was restored to normal and the new Q wave disappeared. The TQ segment returned to normal after approximately 20 min of hypoxic perfusion. Histological analysis showed myocardial infarction in the subendocardium, but not in the subepicardium. In group 2, EPIECG findings during hypoxic blood perfusion were similar to those observed in group 1. However, the recovery of ST segment elevation during normoxic reperfusion was slower than that observed in group 1. R wave restoration did not occur in group 2. Furthermore, the new Q wave remained present throughout the normoxic reperfusion period. Transmural infarction and severe congestion were observed histologically in this group. Obvious contraction bands were not demonstrated histologically in either group. These findings suggest that ADO did not protect myocardial viability during 60 min of hypoxic blood perfusion, but instead, ADO exacerbated ischemic injury during regional hypoxic perfusion.

Adenosine↗

PubMed1989

Does peripheral collateralization also cause collateralization in the canine heart?

1. Experiments were conducted in chronically prepared dogs to determine if gradual obstruction of the proximal femoral arteries would also cause collateralization in the coronary circulation. 2. Peripheral coronary pressure was measured before and after peripheral collateralization as an index of coronary collateral function. Coronary collateral blood flow was measured with radioactive microspheres after peripheral collateralization. 3. Peripheral coronary pressure was not significantly altered by peripheral collateralization. Coronary collateral blood flow measured after peripheral collateralization was similar to that reported in non-collateralized hearts. 4. Results indicated that the mechanism(s) responsible for peripheral collateralization do not act systemically, at least not on the coronary circulation.

Animals↗

PubMed1989

Persistent right coronary flow reserve at low perfusion pressure.

To determine whether right coronary (RC) flow reserve persists at perfusion pressures below the apparent autoregulatory range, the RC artery of 18 anesthetized dogs was cannulated and perfused at controlled pressures. RC blood flow (RCBF) fell from 65.3 +/- 6.1 to 33.7 +/- 2.3 ml.min-1.100 g-1 as RC perfusion pressure (RCPP) was reduced from 80 to 40 mmHg. At 40 mmHg, intracoronary adenosine increased RCBF by 97.9 +/- 10.6 ml.min-1.100 g-1 (P less than 0.001). RCBF fell to 9.5 +/- 1.7 ml.min-1.100 g-1 at 20 mmHg, and RCBF did not significantly increase during adenosine, although RC vasodilation was observed in four dogs. Regional right ventricular (RV) blood flows at RCPP of 80 and 40 mmHg were measured by radioactive microsphere technique. Before adenosine infusion, RCBF was distributed uniformly across the RV free wall at normal and low perfusion pressures. During adenosine infusion, blood flow in both regions increased significantly, but the flow reserve was greater in the subendocardial region at both normal and reduced pressures. RV myocardial O2 consumption (MVo2) was decreased significantly at 40 mmHg, however, there was no evidence of ischemia at this pressure, since the RV lactate extraction ratio was normal (n = 8). Thus RV O2 demand fell when RC O2 supply was reduced, although a flow reserve was available. RV MVo2 was restored to normal when right coronary flow reserve was mobilized by adenosine infusion. For RCBF from 65 to 365 ml.min-1.100 g-1, RC venous O2 content rose and RV MVo2 was essentially constant.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine↗