title: Effects of cardiac denervation on coronary and systemic circulation.
abstract: The effects of cardiac denervation on coronary circulation and systemic hemodynamics were examined in patients who underwent coronary artery bypass grafting for a totally occluded left anterior descending coronary artery. The results in 14 patients who had undergone a combination of bypass grafting and intrapericardial denervation (group I) were compared with those in 19 patients who had undergone only bypass grafting (group II). The heart rate was 110 +/- 4.9 beats/min in group I and 104 +/- 3.7 beats/min in group II after denervation. Although the cardiac index was not significantly different between the two groups, the calculated systemic vascular resistance index of group I (1,358 +/- 111 dynes.s.cm-5.m2) was significantly lower (p < 0.02) than that in group II (1,713 +/- 75 dynes.s.cm-5.m2). The end-diastolic coronary resistance was significantly lower (p < 0.05) in group I (0.59 +/- 0.05 mm Hg.mL-1.min-1) than that in group II (1.04 +/- 0.14 mm Hg.mL-1.min-1), and the end-diastolic graft flow/mean graft flow ratio was 1.56 +/- 0.05 in group I and 1.28 +/- 0.04 in group II (p < 0.01). The plasma norepinephrine concentration in group I (223 +/- 52 pg/mL) was significantly low (p < 0.05) compared with that in group II (328 +/- 39 pg/mL) after denervation. Thus, cardiac denervation may have a beneficial effect on systemic hemodynamics and coronary circulation.
authors.affiliation: Department of Cardiothoracic Surgery, Tokyo Medical and Dental University, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Amano
authors.forename: A
authors.initials: A
authors.lastname: Suzuki
authors.forename: M
authors.initials: M
authors.lastname: Sunamori
mesh_terms: D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003326:Coronary Circulation; D003327:Coronary Disease / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D003714:Denervation / Q000379:methods*; D004837:Epinephrine / Q000097:blood; D005069:Evaluation Studies as Topic; D006439:Hemodynamics; D006801:Humans; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood; D010496:Pericardium / Q000294:innervation*; D013997:Time Factors
chemical_list: D009638:Norepinephrine; D004837:Epinephrine