Adrenergic regulation of coronary microcirculation after extracorporeal circulation and crystalloid cardioplegia

Am J Physiol. 1994 Dec;267(6 Pt 2):H2462-70. doi: 10.1152/ajpheart.1994.267.6.H2462.

Abstract

The purpose of the present study was to examine whether adrenoceptor-mediated responses of porcine coronary resistance arteries are affected by cardioplegic arrest under conditions of extracorporeal circulation (cardiopulmonary bypass; CPB). Pigs were placed on CPB. The hearts were arrested with a cold hyperkalemic crystalloid cardioplegic solution for 1 h, then were reperfused for 1 h. In vivo and in vitro beta-adrenoceptor-mediated responses were compared before CPB and 2 min and 1 h after initiation of reperfusion. In vitro responses were studied in a pressurized no-flow state with video microscopy. Isoproterenol (0.02 micrograms.kg-1.min-1, intracoronary) increased coronary blood flow by 100 +/- 32% (P < 0.001) before CPB and cardioplegic arrest, 17 +/- 7% 2 min postcardioplegia (P < 0.01), and 71 +/- 9 (P < 0.001) after 1 h of reperfusion. Relaxation of precontracted microvessels (90-180 micron) to isoproterenol, NaF, forskolin, and adenosine was reduced after cardioplegic arrest (all P < 0.001). After 1 h of postcardiolegia-reperfusion, relaxation responses to forskolin and adenosine were completely restored, whereas the responses to isoproterenol (P < 0.05) and NaF (P < 0.10) were only partially recovered. Cardioplegic arrest and postcardioplegia-reperfusion blunted the alpha 2-adrenoceptor-mediated endothelium-dependent relaxation to clonidine (P < 0.001) but did not affect the minimal (< 4%) contractile response to the alpha 1-adrenoceptor agonist phenylephrine or the relaxation to nitroprusside. These results show that hyperkalemic cardioplegia results in the generalized defect in the beta-adrenoceptor-GS protein-adenylate cyclase pathway, which is significantly restored after reperfusion.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adenosine / pharmacology
  • Animals
  • Cardioplegic Solutions
  • Cardiopulmonary Bypass
  • Colforsin / pharmacology
  • Coronary Circulation / physiology*
  • Crystallization
  • Extracorporeal Circulation*
  • Female
  • Heart Arrest, Induced*
  • Isoproterenol / pharmacology
  • Male
  • Microcirculation / physiology*
  • Nitroprusside / pharmacology
  • Receptors, Adrenergic / physiology*
  • Receptors, Adrenergic, alpha / drug effects
  • Receptors, Adrenergic, alpha / physiology
  • Receptors, Adrenergic, beta / drug effects
  • Receptors, Adrenergic, beta / physiology
  • Sodium Fluoride / pharmacology
  • Swine
  • Vasodilation / drug effects

Substances

  • Cardioplegic Solutions
  • Receptors, Adrenergic
  • Receptors, Adrenergic, alpha
  • Receptors, Adrenergic, beta
  • Nitroprusside
  • Colforsin
  • Sodium Fluoride
  • Adenosine
  • Isoproterenol