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Calcium antagonists block angiotensin II-mediated vasoconstriction in humans: comparison with their effect on phenylephrine-induced vasoconstriction.

Calcium antagonists are known to decrease peripheral vascular resistance in vivo in humans. The mechanism of this vascular relaxation has not been clearly elucidated. Vascular tone is maintained by several endogenous neurohumoral systems including sympathetic nervous system activity and angiotensin II. We compared and contrasted the capacity of calcium antagonist drugs to prevent angiotensin II and phenylephrine-induced alpha-1 adrenergic vasoconstriction using brachial artery infusion and measurement of forearm blood flow by strain gauge plethysmography. In a dose-dependent manner, calcium antagonists blocked angiotensin II-induced vasoconstriction. The rank order of this blockade was nifedipine greater than verapamil greater than diltiazem. Nifedipine and verapamil, but not diltiazem blocked alpha-1 adrenergic (phenylephrine-induced) vasoconstriction. At 7.64 and 19.1 micrograms/min infusion rates for nifedipine and verapamil, respectively, they abolished the angiotensin II effect; however, the phenylephrine effect was incompletely blocked. Calcium antagonist-induced vascular relaxation in vivo in humans is in part explained by their capacity to block angiotensin II-mediated vasoconstriction. In addition, two calcium antagonists (nifedipine and verapamil) may inhibit alpha-1 adrenergic vasoconstriction.

Adult

Failure of nitroglycerin and diltiazem to reduce platelet-mediated vasoconstriction in dogs with coronary artery stenosis and endothelial injury: further evidence for thromboxane A2 and serotonin as mediators of coronary artery vasoconstriction in vivo.

This study was designed to test the efficacy of nitroglycerin and diltiazem in inhibiting in vivo platelet aggregation and reducing platelet-mediated vasoconstriction in a canine model of coronary artery stenosis and endothelial injury. Coronary artery diameter was measured in vivo by means of ultrasonic crystals sutured on the left anterior descending coronary artery (LAD) immediately distal to an external constrictor (LAD1), 1 cm below (LAD2), and on the left circumflex coronary artery. Coronary diameter was continuously measured before, during cyclic flow variations (progressive declines in blood flow followed by sudden restorations of flow due to recurrent intracoronary platelet aggregation), during cyclic flow variations and intravenous infusion of nitroglycerin (5 micrograms/kg per min) or diltiazem (15 micrograms/kg per min), and after cyclic flow variations were abolished by administration of LY53857, a serotonin receptor antagonist (n = 7), or SQ29548, a thromboxane A2 receptor antagonist (n = 7). During control cyclic flow variations, at the nadir of coronary flow (6% to 11% of the nonstenosed values), LAD1 cross-sectional area decreased by 43 +/- 8% and 44 +/- 3% in the two groups of dogs subsequently treated with LY53857 and SQ29548, respectively. Neither nitroglycerin nor diltiazem caused changes in cyclic flow variation frequency or severity. Furthermore, neither drug significantly reduced the vasoconstriction associated with cyclic flow variations, whereas they significantly increased circumflex artery cross-sectional area. In contrast, LY53857 and SQ29548 were very effective in abolishing cyclic flow variations and the coronary vasoconstriction related to them. Five additional dogs received an intracoronary infusion of nitroglycerin (21 +/- 5 micrograms/kg per min) and later diltiazem (15 micrograms/kg per min).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals

Vasoconstrictions mediated by an endothelium-derived vasoconstricting factor (EDCF).

To enlighten the role of endothelium in the generation of vasospasms we examined vascular tone after reduction of oxygen supply in dependence on endothelial function in isolated vessels (rabbit aorta abdominalis, pig coronary, and pulmonary artery). Therefore, after ligation of all side branches, vessel segments, prepared either with or without endothelium, were cannulated and arranged in two systems (with two segments each) in a serial manner (system I: endothelium-denuded vessel followed by an endothelium-denuded segment) and perfused with Tyrode's solution (constant flow 20 ml/min). Pressure gradient over each segment was continuously measured. Endothelial function was checked by perfusion with 1 mumol/l actetylholine after precontraction with 0.1 mumol/l norepinephrine, thereby inducing an EDRF mediated vasodilation (greater than 70%) indicating normal endothelial function. After 2 h equilibration with Tyrode's solution the preparations of rabbit aorta abdominalis were perfused for 30 min with oxygen-deprived medium (reduction from 95% O2 and 5% CO2 to 95% N2 and 5% CO2) and a marked long lasting (60 min) increase in pressure gradient (indicating vasoconstriction) was observed in those endothelium-denuded vessel segments which were mounted distal to a normal vessel with an intact endothelium. This contraction could be inhibited by pretreatment with either 1 mumol/l dexamethasone. 1 mumol/l indomethacine or 10 mumol/l methylene blue or attenuated by the TXA2-antagonist BM 17133 (5 mumol/l) but not by radical scavengers as superoxid dismutase or by inhibition of the lipoxygenase by nordihydroguaretic acid. From these results it is concluded that endothelium releases a vasoconstricting factor (EDCF) at pO2 values beneath 550 mm Hg. This EDCF seems to depend on phospholipase A2 and cyclooxygenase, but because of the long-lasting effect it is probably no prostanoid itself, especially not TXA2.

Animals

[Reflexphotometric determinations of vasoconstriction after topical application of steroids. IV. Time slope of vasoconstriction and reactive vasodilatation (author's transl)].

In this study a reflex photometrical technique has been used to examine local steroid induced vasoreactions. When applied but once, steroids cause a maximum vasoconstriction between 8 and 16 h after beginning the test. Followed by a 32 h period, the phase of vasoconstriction is succeeded by a dilatation of dermis blood vessels. It appears, that the stronger the vasocontriction, the smaller the degree of vasodilatation.

Administration, Topical

[Reflexphotometric determinations of vasoconstriction after topical application of steroids. V. Vasoconstriction phaenomenon and tachyphylaxis after repeated steroid application (author's transl)].

On the basis of reflexphotometrical vasoconstriction tests it is demonstrated, that the intensity of vasoreactions caused by a first topical application of steroids, diminishes rapidly after repeated applications, until there is no response of vessels to a new application. This phaenomenon is know as tachyphylaxis and has been found in all tested glucocorticoids.

Administration, Topical

Determinants of renal actions of atrial natriuretic peptide. Lack of effect of atrial natriuretic peptide on pressure-induced vasoconstriction.

We have previously demonstrated that atrial natriuretic peptide (ANP) completely reverses norepinephrine-induced afferent arteriolar (AA) vasoconstriction. In the present study we characterized the effects of ANP on pressure-induced vasoconstriction of AA. Chronic unilateral hydronephrosis was induced to facilitate direct visualization of the renal microcirculation. Hydronephrotic kidneys were perfused in vitro, and AA diameters were measured during stepwise alterations in renal arterial pressure. Increasing renal arterial pressure from 80 to 180 mm Hg decreased AA diameter by 22 +/- 2% (from 18.5 +/- 1.0 to 14.4 +/- 1.0 microns, p less than 0.005). In the presence of 100 nM ANP [human ANP-(4-28)], AA vasoconstricted by 23 +/- 4%, indicating that ANP failed to modify the pressure-induced AA vasoconstriction. Furthermore, both nitroprusside (10 microM) and 8-bromoguanosine 3':5'-cyclic monophosphate (30 microM) only partially inhibited pressure-induced AA vasoconstriction (31 +/- 5% and 47 +/- 7%, respectively), whereas these vasodilators completely abolished norepinephrine-induced AA vasoconstriction. In contrast, nifedipine completely inhibited pressure-induced AA vasoconstriction. In summary, pressure-induced AA vasoconstriction is insensitive to the action of ANP, is relatively refractory to cyclic GMP-mediated vasorelaxation, but is completely inhibited by calcium channel blockade. Furthermore, since ANP completely abolishes norepinephrine-induced vasoconstriction but fails to affect pressure-induced vasoconstriction, it is apparent that the type of underlying vasoconstrictor stimuli constitutes a major determinant of the renal microvascular response to ANP.

Animals

Almitrine mimics hypoxic vasoconstriction in isolated rat lungs.

The effect of almitrine bimesylate or the solvent malic acid on pulmonary vascular perfusion pressure was assessed in isolated rat lungs and on the contractile behavior of rat aorta and main pulmonary artery rings. Addition of almitrine to the lung perfusate during normoxia caused a dose-dependent, transient increase in pulmonary artery pressure with no change of the lung microvascular pressure. In systemic or pulmonary conduit arteries, the contractile tension was unaffected by almitrine. This indicates a precapillary locus of drug action. We also examined almitrine's effect on hypoxic pulmonary vasoconstriction (HPVC) in isolated lungs perfused with blood or with physiological salt solution (PSS). Low-dose almitrine potentiated hypoxic vasoconstriction in blood- but not in PSS-perfused lungs. However, a high dose of almitrine reduced hypoxic vasoconstriction dose dependently. When almitrine was added to the lung perfusate during hypoxia- or cyanide-induced (NaCN, 5 x 10(-5) M) pulmonary vasoconstriction, almitrine caused no further vasoconstriction. However, when the pulmonary perfusion pressure was elevated by KCl (20 mM) to the same magnitude as by alveolar hypoxia or cyanide, almitrine elicited a pressor response comparable to that observed during normoxia. Almitrine-induced pulmonary vasoconstriction resembled hypoxic vasoconstriction in that agents known to enhance hypoxic vasoconstriction (phorbol myristate acetate, vanadate, and 4-aminopyridine) enhanced, and known inhibitors of HPVC (the Ca2+ entry blocker nifedipine and hypothermia) inhibited, the almitrine-induced vasoconstriction. These findings lead us to speculate that almitrine also affects the oxygen-sensing limb of the hypoxic pressor response, not simply the effector (contractile apparatus of the vascular muscle cell).

Almitrine

Thermoregulatory vasoconstriction during propofol/nitrous oxide anesthesia in humans: threshold and oxyhemoglobin saturation.

To determine the thermoregulatory effects of propofol and nitrous oxide, we measured the threshold for peripheral vasoconstriction in seven volunteers over a total of 13 study days. We also evaluated the effect of vasoconstriction on oxyhemoglobin saturation (SpO2). Anesthesia was induced with an intravenous bolus dose of propofol (2 mg/kg), followed by an infusion of 180 micrograms.kg-1 x min-1 for 15 min, and maintained with 60% nitrous oxide and propofol (80-160 micrograms.kg-1 x min-1). Central and skin surface temperatures and SpO2 (using two different pulse oximeters) were measured continuously; plasma propofol concentrations and arterial PO2 were measured at 15-min intervals. Volunteers were cooled with a circulating water blanket until definitive peripheral vasoconstriction was detected. The tympanic membrane temperature triggering vasoconstriction was considered the thermoregulatory threshold. Vasoconstriction developed on seven study days during propofol/nitrous oxide anesthesia at a central temperature of 33.3 +/- 1.0 degrees C (mean +/- SD) and plasma propofol concentration of 3.9 +/- 1.1 micrograms/mL. The thresholds during anesthesia were significantly lower than those during the control period (36.7 +/- 0.3 degrees C), but the correlation between plasma propofol concentrations and vasoconstriction thresholds was poor. On the remaining six study days, vasoconstriction did not develop despite central temperatures ranging from 32.1 to 32.7 degrees C. Corresponding propofol concentrations were 4.1-10.9 micrograms/mL. These data suggest that anesthesia with propofol, in typical clinical concentrations, and 60% nitrous oxide substantially inhibits thermoregulatory vasoconstriction. Vasoconstriction increased SpO2 by approximately 2% without a significant concomitant change in PO2. The observed increase in SpO2 probably reflects decreased transmission of arterial pulsations to venous blood in the finger.

Adult

Vanadate potentiates hypoxic pulmonary vasoconstriction.

Vanadate, an essential trace element and an inhibitor or stimulator of many enzymes, potentiates the hypoxic vasoconstriction in isolated lung preparations. However, the mechanism of action of vanadate in the lung circulation is unclear. We compared, in isolated rat lungs, the effect of vanadate (3 x 10(-5) M) on hypoxia-induced vasoconstriction with the vasoconstriction caused by angiotensin II, KCl or NaCN, and found that vanadate preferentially enhanced the hypoxia- and NaCN-induced pressor responses. Vanadate also shifted the stimulus-response curve for oxygen such that vasoconstriction occurred at a higher PO2 than in control lungs, indicating that vanadate had affected the oxygen sensing mechanism in the lungs. We postulated that vanadate might potentiate hypoxic vasoconstriction, in part, by activating a protein kinase C (PKC), and compared the effect of phorbol myristate acetate (PMA; 5 x 10(-8) M) on hypoxic vasoconstriction with that of vanadate. Both agents, PMA and vanadate, potentiated hypoxic vasoconstriction transiently and to a similar degree and the potentiation by both agents was blocked by staurosporine (1 microgram/ml), a PKC inhibitor, and 2-nitro-4-carboxyphenyl-N,N-diphenylcarbamate, a phospholipase C inhibitor, and partially reduced by the Ca++ entry inhibitor nifedipine. We conclude that the similarities between the action of PMA and vanadate in isolated lungs point toward an involvement of the PKC in the mechanism of vanadate-induced potentiation of hypoxic vasoconstriction. In addition, our data indicate that potentiation of hypoxic vasoconstriction by PMA or vanadate may occur, in part, independent of voltage-dependent Ca++ entry.

Animals

Interactions between hypoxic and almitrine-induced vasoconstriction in the rat lung.

1. To test whether almitrine might improve the arterial partial pressure of O2 in patients with chronic obstructive airways disease by improvement of ventilation-perfusion matching, we looked at the interaction between hypoxic and almitrine-induced vasoconstriction in isolated rat lungs perfused with blood at constant flow. Increases in pressure represented increases in resistance. 2. Almitrine, given in increasing doses between challenges with 2% O2, enhanced hypoxic vasoconstriction at low doses but attenuated it at high doses. 3. Stimulus-response curves to hypoxia of increasing severity gave a sigmoid curve. 4. Almitrine solvent caused small changes in pulmonary artery pressure and shifted the stimulus-response curve slightly in a parallel fashion. 5. Small doses of almitrine enhanced the action of mild to moderate hypoxia, medium doses attenuated moderately severe hypoxia, whereas high doses depressed vasoconstriction due to all degrees of hypoxia. 6. These effects of almitrine on hypoxic vasoconstriction were compared with the effect of solvent by analysis of variance; the results substantiated significant enhancement of hypoxia by small doses and attenuation by large doses. 7. In patients, if similar effects apply, small doses of almitrine would assist ventilation-perfusion matching, but large doses might worsen it. 8. Almitrine-induced vasoconstriction was attenuated by a fall in perfusate temperature in a similar manner to hypoxic vasoconstriction. It was also attenuated by three drugs, chlorpheniramine, propanolol and diethylcarbamazine, all of which also decrease hypoxic vasoconstriction. The similarity between hypoxic and almitrine-induced pulmonary vasoconstriction is further confirmed.

Almitrine

Thermoregulatory vasoconstriction during isoflurane anesthesia minimally decreases cutaneous heat loss.

The authors tested the extent to which thermoregulatory vasoconstriction decreases cutaneous heat loss during isoflurane anesthesia. Thermoregulatory vasoconstriction was provoked by central hypothermia in five nonsurgical volunteers given isoflurane anesthesia. Peripheral arteriovenous shunt flow was quantified using forearm-fingertip skin-surface temperature gradients and volume plethysmography. Capillary blood flow on the chest was evaluated using laser Doppler flowmetry. The central temperature triggering peripheral vasoconstriction (the thermoregulatory threshold) was 34.6 +/- 0.4 degrees C. Central body temperature decreased less than or equal to 0.2 degrees C in the period from 1 h preceding onset of significant vasoconstriction until 1.5 h afterward. Chest skin-surface blood flow decreased 21% during the period from 2 h before to 1 h after significant fingertip vasoconstriction. In contrast, fingertip blood flow decreased approximately 50-fold in the same period. The correlation between fingertip blood flow and skin-temperature gradient was excellent. Total heat loss decreased approximately 26% (25.3 +/- 3.9 W) in the period from 2 h before significant peripheral vasoconstriction to 1 h afterward. Loss from the arms and legs (upper arm, lower arm, thigh, and calf) decreased approximately 24% in the same period. Heat loss from the trunk and head decreased only 14%; in contrast, loss from the hands and feet decreased approximately 57%. There were no clinically important changes in blood pressure or heart rate during vasoconstriction, but oxyhemoglobin saturation (measured by pulse oximetry) increased slightly. These data suggest that thermoregulatory vasoconstriction only minimally decreases cutaneous heat loss.

Adult

Postsynaptic alpha 1- and alpha 2-adrenergic mechanisms in coronary vasoconstriction.

This study examined the relative importance of postsynaptic alpha 1- and alpha 2-adrenoceptors in mediating coronary vasoconstriction in open chest dogs in which the left circumflex coronary artery was cannulated and perfused at a constant rate. The cervical vagus nerves and central connections of the stellate ganglia were transected, and beta-adrenergic blockade was produced with propranolol. Coronary vasoconstriction occurred in response to intraarterial administration of both the alpha 1-agonist phenylephrine and the alpha 2-agonist BHT 933. The response to phenylephrine was partially blocked with prazosin and nearly completely eliminated by yohimbine. The response to BHT 933 was resistant to prazosin, but almost completely blocked by yohimbine. Coronary vasoconstriction produced by norepinephrine was resistant to prazosin, but was blunted by alpha 2-adrenergic blockade with yohimbine or idazoxan. Prazosin produced some blunting of coronary vasoconstriction in response to small doses of epinephrine, while yohimbine markedly attenuated epinephrine-induced vasoconstriction at all doses used. Measurements of regional myocardial blood flow with radioactive microspheres demonstrated no transmural redistribution of perfusion during vasoconstriction produced by either alpha 1- or alpha 2 stimulation. Thus, although stimulation of both alpha 1- and alpha 2-adrenoceptors is capable of causing coronary vasoconstriction, vasoconstriction in response to norepinephrine and epinephrine is mediated principally by postsynaptic alpha 2-adrenoceptors.

Animals

Endothelium-dependent arterial vasoconstriction after balloon angioplasty.

To determine whether balloon angioplasty can provoke arterial vasoconstriction independent of platelet aggregation and neurogenic input, we studied the spontaneous vasomotor effects of balloon dilatation in isolated, perfused whole-vessel segments of rabbit aorta and pig carotid artery. Freshly dissected rabbit thoracic aortas were mounted in a muscle bath-perfusion chamber, perfused with physiologic saline solution at 70 mm Hg, and allowed to equilibrate. The proximal or distal half of the aortas were dilated with either a "large" (5 mm, 31-51% stretch beyond relaxed diameter) or a "small" (4 mm, 5-16% stretch) balloon angioplasty catheter with the other half of the vessel serving as the control. A similar series of experiments were performed in pig carotid arteries using "large" (6 or 8 mm, 48-90% stretch) balloon catheters. The spontaneous vasomotor effects of balloon angioplasty were examined with long-axis, high-frequency ultrasonic imaging combined with computerized edge detection image processing to measure changes in segmental internal vessel diameters. Additional experiments were carried out in rabbit aortas to determine the roles of the endothelium, extracellular calcium, indomethacin, ibuprofen, and calcium-channel blockade in modulating angioplasty-induced vasoconstriction. Significant arterial vasoconstriction was observed in the balloon angioplasty segments after dilatation with 5-mm balloons but not with 4-mm balloons. After dilatation with 5-mm balloons, the angioplasty segments' cross-sectional areas decreased by an average of 31% versus 4% for the nondilated (control) segments (p less than 0.0001). Similar postangioplasty vasoconstriction was observed in the pig carotid arteries (decrease in minimal vessel cross-sectional area of 41% [angioplasty segment] versus 2% [control segment]) (p less than 0.005). This angioplasty-induced vasoconstriction was prevented by endothelial denudation before angioplasty, removal of extracellular calcium, and pretreatment with indomethacin or ibuprofen. The vasoconstriction was only partially inhibited by calcium channel blockade with verapamil. These findings demonstrate that stretch-pressure-induced arterial vasoconstriction may occur after balloon angioplasty, independent of platelet aggregation and neurogenic input. This angioplasty-induced vasoconstriction appears to be mediated by an endothelially derived cyclooxygenase product(s).

Angioplasty, Balloon

Adenosine produces pulmonary vasoconstriction in sheep. Evidence for thromboxane A2/prostaglandin endoperoxide-receptor activation.

Adenosine, an intermediate product in the metabolism of ATP, is thought to produce vasodilation in all vascular beds with the exception of the kidney. Due to its theoretical potential as a pulmonary vasodilator, we studied the hemodynamic effects of adenosine in the pulmonary vasculature of chronically instrumented awake sheep. Adenosine produced significant pulmonary vasoconstriction instead of the expected vasodilatation. Bolus injections of adenosine into the superior vena cava produced a dose-dependent increase in pulmonary artery pressure that was entirely due to an increase in vascular resistance, since cardiac output decreased slightly. This effect is produced via activation of specific cell surface adenosine receptors, since it was blocked by the adenosine-receptor antagonists theophylline and dipropylsulfophenylxanthine. The cell type involved in adenosine-induced pulmonary vasoconstriction appears to be located within the lung, since vasoconstriction was blunted when adenosine was infused into the left atrium, distal to the lung. However, adenosine does not directly vasoconstrict the pulmonary vasculature, because its effect could be completely abolished by cyclooxygenase inhibition with either indomethacin or ibuprofen and by a thromboxane A2/prostaglandin endoperoxide-receptor antagonist (SQ 29,548). Adenosine-induced vasoconstriction was also greatly reduced after inhibition of thromboxane synthesis. Thus, adenosine produced pulmonary vasoconstriction through generation of a thromboxane/endoperoxide product. Whether endogenous adenosine is involved in the generation of pulmonary vasoconstriction seen in pathophysiological states remains to be determined. To our knowledge, this is the first clear evidence for adenosine-induced vasoconstriction outside the kidney and for an interaction between adenosine and eicosanoid mechanisms.

Adenosine

Mechanism of postarrhythmic renal vasoconstriction in the anesthetized dog.

The mechanism of postarrhythmic renal vasoconstriction was studied in 28 dogs anesthetized with pentobarbital sodium (30 mg/kg i.v.). Rapid atrial or ventricular pacing or induction of atrial fibrilation were used to produce at least 20% prompt decrease in cardiac output and mean arterial blood pressure. Return to control cardiac output and blood pressure occurred within 3 minutes after cessation of the arrhythmia, but renal blood flow remained significantly decreased (26%) with gradual recovery by 17.7 +/- 6.6 min. Infusion of phentolamine (0.25 mg/min) into the renal artery, intravenous hexamethonium (l mg/kg), adrenal demedullation, or cooling the cervical vagi prevented postarrhythmic renal vasoconstriction. In contrast, renal denervation, intravenous bretylium (10 mg/kg), intravenous atropine (0.5 mg/kg) or intrarenal SQ 20881 (0.20 mg/min) has no effect on postarrhythmic renal vasoconstriction. Intravenous propranolol (0.5 mg/kg) intensified postarrhythmic renal vasoconstriction. These data suggested that the postarrhythmic renal vasoconstrictive response required intact vagi and was due to alpha adrenergic stimulation by adrenal catecholamines. However, femoral arterial catecholamine levels were not elevated above control during postarrhythmic renal vasoconstriction. We therefore sought local vascular pathways by which catecholamines might reach the kidneys. An adrenorenal vascular network was found in each dog. Collection of catecholamines from these vessels during postarrhythmic renal vasoconstriction in six dogs revealed catecholamine concentrations threefold higher than simultaneously collected femoral arterial catecholamines levels. Because ligation of these vessels abolished postarrhythmic renal vasoconstriction in each dog, we conclude that postarrhythmic renal vasconstriction is due to adrenal catecholamines reaching the kidneys through an adreno-renal vascular network and that the response requires intact vagi.

Adrenal Glands

Spontaneous and pharmacologically-induced vasoconstrictive responses of rat aortic rings are attenuated by balloon angioplasty.

The effects of arterial dilatation with differently sized PTCA catheters on prestretch-induced, receptor-induced and voltage-induced vasoconstriction was investigated. Rat aortic rings were kept incubated in HEPES buffer for 0,3,6, and 12 hours before mounting in the experimental set-up for contraction measurements. Balloon dilation (BD) was applied prior to incubation or directly before measurement following a period of incubation. Isometric force was measured after applying a prestretch to the vascular rings. The ring then contracted spontaneously or, if not, was brought to contraction by norepinephrine (NE, 50 microM) or potassium ions (K+, 30 mM). Prestretch-induced vasoconstriction reached maximum values after 6 hours of incubation. NE-induced vasoconstriction was maximal at 6 hours of incubation and K(+)-induced vasoconstriction kept rising up to 12 hours of incubation. The addition of enoximone resulted in vasodilatation (ED50 = 0.1 microM) of prestretch-induced vasoconstriction, but was less potent (ED50 = 168 microM) if added to NE-induced or K(+)-induced vasoconstricted rings. BD applied before the incubation period reduced prestretch-induced, receptor-induced and voltage-induced contractions (the effectivity decreasing in that order) and did not elicit vasospastic activity. BD applied after the incubation period and immediately before the contraction measurements prevented the occurrence of prestretch-induced spontaneous contractions, caused a nonsignificant (p = 0.08) decrease of NE-induced vasoconstriction, and had no effect on K(+)-induced vasoconstriction. It is concluded that this model to study spontaneous and induced vasoactivity elucidates the consequences of the application of balloon dilatation in nonatherosclerotic vascular rings.

Angioplasty, Balloon

Evidence for two separate vasoconstriction-mediating nucleotide receptors, both distinct from the P2x-receptor, in rabbit basilar artery: a receptor for pyrimidine nucleotides and a receptor for purine nucleotides.

Uridine 5'-triphosphate- (UTP-) and adenosine 5'-triphosphate- (ATP) induced vasoconstriction was studied in the rabbit basilar artery. The arteries were incubated and perfused at a constant rate of flow. Vasoconstriction was measured as an increase in perfusion pressure. Serotonin, histamine and noradrenaline caused concentration-dependent vasoconstriction, with potency decreasing in that order. Of the nucleotides tested, UTP, UDP, UMP, CTP, ATP, ADP, adenosine 5'-O-(3-thio)-triphosphate (ATP gamma S), and beta,gamma-imido adenosine 5'-triphosphate (AMP-PNP) elicited concentration-dependent vasoconstriction, whereas AMP, 2-methylthio-ATP, alpha,beta-methylene-ATP and beta,gamma-methylene-ATP up to 10(-3) mol/l caused no or only a very small increase in perfusion pressure. The order of potency of the pyrimidine nucleotides was: UTP = UDP much greater than UMP = CTP; that of the purine nucleotides was: ATP gamma S greater than AMP-PNP greater than ATP greater than ADP greater than 2-methylthio-ATP = alpha,beta-methylene-ATP = beta,gamma-methylene-ATP. The vasoconstrictor effects of UTP and ATP were not or only to a minor degree influenced by: phentolamine; a mixture of atropine, diphenhydramine and methysergide; indomethacin; nordihydroguaiaretic acid; denervation by 6-hydroxydopamine; or mechanical removal of endothelium. Prolonged exposure to alpha,beta-methylene-ATP elicited only a very small vasoconstriction and did not change the constrictor effects of UTP or ATP. Prolonged exposure to ATP gamma S elicited marked vasoconstriction; subsequently, responses to ATP were reduced whereas those to UTP were, if anything, slightly enhanced. Reactive blue 2 reduced neither the UTP- nor the ATP-induced vasoconstriction.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals

Thermoregulatory thresholds for vasoconstriction in pediatric patients anesthetized with halothane or halothane and caudal bupivacaine.

The thermoregulatory threshold for vasoconstriction has been studied in infants and children given isoflurane, but not in those given halothane anesthesia. More importantly, the effect of vasoconstriction on central temperature in pediatric patients remains unknown. Also unknown is the effect of caudal analgesia on vasoconstriction thresholds. Accordingly, in the first portion of this study, we determined the central thermoregulatory threshold in 23 infants and children given approximately 0.6% halothane and caudal anesthesia for abdominal surgery. Patients were prospectively assigned to one of four weight groups: 5-10, 10-20, 20-30, and 30-50 kg. The threshold was considered the central temperature triggering peripheral vasoconstriction, and significant vasoconstriction was defined as a forearm-fingertip skin-surface temperature gradient exceeding 4 degrees C. Thresholds were similar (approximately 35.7 degrees C) in each study group, suggesting that thermoregulatory responses to halothane anesthesia are similar in infants and children of differing weights. However, they were higher than expected based on the previously reported thresholds in pediatric patients given isoflurane anesthesia. After peripheral vasoconstriction, central temperature continued to decrease in patients weighing more than 30 kg but remained constant or increased slightly in the others. These data suggest that thermoregulatory responses are more effective in infants and small children than in bigger children or adults. In the second part of this study we evaluated the effect of caudal analgesia on the thermoregulatory threshold for vasoconstriction. Children undergoing hypospadias repair were anesthetized with halothane (0.9%) and oxygen. Following induction, they were randomly assigned to caudal analgesia (n = 7) or penile nerve block (n = 6).(ABSTRACT TRUNCATED AT 250 WORDS)

Anesthesia, Caudal