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European Heart Journal 2001 22(23):2209-2216; doi:10.1053/euhj.2001.2629
Copyright © 2001 by the European Society of Cardiology.
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Vasodilator pre-treatment of human radial arteries; comparison of effects of phenoxybenzamine vs papaverine on norepinephrine-induced contraction in vitro

W. E. Harrisona, A. J. Mellorb, J. Clarkb and D. R. J. Singera,f1

a Departments of Pharmacology and Clinical Pharmacology, St George's Hospital Medical School, London, U.K.
b Anaesthetics, St George's Hospital Medical School, London, U.K.

Received December 20, 2000; accepted February 7, 2001

Abstract

Aims The radial artery, increasingly used for coronary artery bypass grafting (CABG), has a potential for spasm which may increase peri-operative risk. Increased alpha-adrenoceptor activation is a key candidate for the spasm. We studied the effects of vasoconstriction in a radial artery, which had undergone brief exposure to the alpha-adrenoceptor antagonist phenoxybenzamine vs the opioid derivative papaverine.

Methods and Results Using standard classical organ bath techniques, concentration responses were obtained to norepinephrine in segments of radial artery from 12 CABG patients pre- and post-incubation for 20min in either phenoxybenzamine 10–6 or papaverine 3x10–3. Responses were reassessed 2, 4 and 18h after washout of phenoxybenzamine and 2, 4, 8 and 18h after washout of papaverine. There was concentration-dependent constriction to norepinephrine (maximum response 0·89±0·20 (SEM) g.mm–1, n=6). Constriction to norepinephrine was abolished immediately after incubation in phenoxybenzamine and remained completely inhibited for at least 18h (P<0·0001 ANOVA phenoxybenzamine pre-treated vs controls). Most of the inhibition of concentration-dependent constriction to norepinephrine following pre-treatment with papaverine was lost 8h later.

Conclusion Radial artery vasoconstriction induced by a clinically relevant agonist, norepinephrine, may be prevented for at least 18h by pre-incubation in phenoxybenzamine, in contrast to the brief inhibition achieved by pre-treatment with papaverine. Adding phenoxybenzamine to radial artery graft bathing solution may improve early outcome following CABG.

Key Words: Coronary disease, norepinephrine, alpha adrenergic receptors, surgery, vasoconstriction

f1 Correspondence: Dr D. R. J. Singer, Department of Pharmacology and Clinical Pharmacology, St George's Hospital Medical School, Cranmer Terrace, London SW17 0RE, U.K.

References

  1. Carrel T, Kajawski T, Zund G. The internal mammary artery malperfusion syndrome: incidence, treatment and angiographic verification. Eur J Cardiothoracic Surg. 1995;9:190–195[Abstract]
  2. Buxton B, Windsor M, Komeda M. How good is radial artery as a bypass graft? Coronary Art Dis. 1997;8:225–233[Web of Science][Medline]
  3. Acar C, Jebara V, Portoghese M. Revival of the radial artery for coronary artery bypass grafting. Ann Thorac Surg. 1992;54:652–659[Abstract]
  4. Manasse E, Sperti G, Suma H. Use of the radial artery for myocardial revascularisation. Ann Thorac Surg. 1996;62:1076–1082[Abstract/Free Full Text]
  5. Taggart D, Dipp M, Mussa S, Nye P. Phenoxybenzamine prevents spasm in radial artery conduits for coronary artery bypass grafting. J Cardiovascular Surg. 2000;120:815–817
  6. Borland JA, Chester AH, Yacoub MH. Enhanced vasoreactivity of the human saphenous vein to angiotensin I and II: implications for its performance as a bypass graft. Circulation. 1996;94:40
  7. Garret HE, Dennis EW, DeBakey ME. Aorto-coronary bypass with saphenous vein graft. JAMA. 1973;223:792–794[Abstract/Free Full Text]
  8. Favoloro RG. Saphenous graft autograft replacement of severe segmental coronary artery occlusion: Operative technique. Ann Thorac Surg. 1968;5:334–339[Medline]
  9. Johnson WD, Flemma RJ, Lepley D. Extended treatment of severe coronary artery disease. A total surgical approach. Ann Surg. 1969;170:460–470[Web of Science][Medline]
  10. Grondin CM, Campeau L, Lesperance J. Comparison of late changes in internal mammary artery and saphenous vein grafts in 2 consecutive series of patients 10 years after operation. Circulation. 1984;70:II208–II212
  11. Singh RN, Sosa JA, Green GA. Long-term fate of the internal mammary artery and saphenous vein grafts. J Thoracic Cardiovasc Surg. 1983;86:359–363[Abstract]
  12. Cameron A, Harvey GK, Green GE. Bypass surgery with the internal mammary artery graft: 15 year follow-up. Circulation. 1986;74:III-30[Medline]
  13. Carpentier A, Guermonprez JL, Deloche A. The aorto-to-coronary radial artery bypass graft. Ann Thorac Surg. 1973;16:111–121[Medline]
  14. Fisk RL, Brooks CH, Callaghan JC, Dvorkin J. Experience with the radial artery graft for coronary artery bypass. Ann Thorac Surg. 1976;21:513–518[Abstract]
  15. DaCosta F, DaCosta I, Poffo R. Myocardial revascularisation with the radial artery: a clinical and angiographic study. Ann Thorac Surg. 1996;62:475–480[Abstract/Free Full Text]
  16. Downing SW, Edwards LH. Release of vasoactive substances during cardiopulmonary bypass. Ann Thorac Surg. 1992;54:1236–1243[Abstract]
  17. Chester AH, Amrani M, Borland JAA. Vascular biology of the radial artery. Curr Opin Cardiol. 1998;13:447–452[Web of Science][Medline]
  18. Massa G, Johansson S, Kimblad P. Might free arterial grafts fail due to spasm? Ann Thorac Surg. 1991;51:94–101[Abstract]
  19. Cooper GJ, Wilkinson GAL, Angelinin GD. Overcoming peri-operative spasm of the internal mammary artery. Which is the best vasodilator? J Thorac Cardiovasc Surg. 1992;104:465–468[Abstract]
  20. He GW, Yang CQ. Use of verapamil and nitroglycerin solution in preparation of radial artery for coronary grafting. Ann Thorac Surg. 1996;61:610–614[Abstract/Free Full Text]
  21. Shapira O, Xu A, Vita J. Nitroglycerin is superior to diltiazem as a coronary bypass conduit vasodilator. J Thorac Cardiovasc Surg. 1999;117:906–911[Abstract/Free Full Text]
  22. He GW, Yang CQ. Comparison of the vasorelaxant effect of nitroprusside and nitroglycerin in the human radial artery in vitro. Br J Clin Pharmacol. 1999;48:99–104[CrossRef][Web of Science][Medline]
  23. Vesey CJ, Stringer M, Cole PV. Decay of nitroprusside. I: in vitro. Br J Anaesth. 1990;64:696–703[Abstract/Free Full Text]
  24. Cable DG, Caccitolo JA, Pearson PJ. New approaches to prevention and treatment of radial artery graft vasospasm. Circulation. 1998;98:II-15–II-22[Web of Science][Medline]
  25. Firmin RK, Boulous P, Allen P, Lime RC, Lincoln LCR. Sympathoadrenal function during cardiac operations in infants with the technique of surface cooling, limited cardio-pulmonary bypass, and circulatory arrest. J Thorac Cardiovasc Surg. 1985;90:729–735[Abstract]
  26. Reves JG, Karp RB, Buttner EE. Neuronal and adreno-medullary catecholamine release in response to cardiopulmonary bypass in man. Circulation. 1982;66:49–55[Abstract/Free Full Text]
  27. Norel X, Walch L, Costantino M. M1 and M3 muscarinic receptors in human pulmonary arteries. Br J Pharmacol. 1996;119:149–157[Web of Science][Medline]
  28. Allen GS, Henderson LM, Chou SN. Cerebral arterial spasm. 2. In vitro contractile activity of serotonin in human serum and CSF on the canine basilar artery, and its blockage by methylsergide and phenoxybenzamine. J Neurosurg. 1974;40:442–450[Web of Science][Medline]
  29. Zimmerman BG, Sybertz EJ, Wong PC. Interaction between sympathetic and renin-angiotensin system. J Hypertension. 1984;2:581–588[CrossRef][Medline]
  30. Levene DL, Freeman MR. Alpha-adrenoceptor-mediated coronary artery spasm. JAMA. 1976;236:1018–1022[Abstract/Free Full Text]
  31. Ensinger H, Stein B, Jager O. Relationship between infusion rates, plasma concentrations, and cardiovascular and metabolic effects during the infusion of norepinephrine in healthy volunteers. Crit Care Med. 1992;20:1250–1256[Web of Science][Medline]
  32. He G-W, Yang C-Q. Inhibition of vasoconstriction by the thomboxane A2 antagonist GR3219B in the human radial artery. Br J Clin Pharmacol. 1999;48:207–215[CrossRef][Web of Science][Medline]

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