Neurally mediated depressor hemodynamic response induced by intracoronary catheter balloon inflation in pigs.
OBJECTIVE
To assess whether intracoronary catheter balloon inflation triggers a neurally mediated hemodynamic response that interacts with the ischemia-induced myocardial dysfunction.


METHODS
Forty-eight chloralose anesthetized pigs underwent a 60 s intraluminal catheter balloon inflation of the proximal left anterior descending (LAD) coronary artery before and after one of these treatments: disruption of LAD pericoronary nerves with phenol (n=6), bilateral stellectomy (n=8), bilateral cervical vagotomy (n=6), atropine (n=5), and ganglionic blockade with hexamethonium (n=10). In 13 other pigs, we assessed the reproducibility of two balloon inflations spaced 15 min (n=6) or 60 min (n=7). The ECG, left ventricular (LV) pressure, and LV dP/dt were recorded during each intervention. Right ventricular (RV) pressure, RV dP/dt, and aortic blood flow were also measured in a subset of pigs.


RESULTS
Balloon inflation induced an early (10 s) and reproducible (ANOVA, P<0.001) drop in systolic pressure and peak dP/dt; a decrease in aortic blood flow; a rise in end-diastolic pressure; and elevation of the ST segment. Pericoronary denervation, stellectomy and ganglionic blockade attenuated (P<0.001) the drop in LV parameters during coronary inflation, but atropine and vagotomy did not.


CONCLUSIONS
A depressor hemodynamic response subserved by pericoronary nerves worsens the LV dysfunction induced by brief coronary catheter balloon inflation in anesthetized pigs. Cholinergic fibers do not appear to play a major role.
Cinca
J
J
Servicio de Cardiología, Hospital General Universitari Vall d'Hebron, 08035, Barcelona, Spain. jcinca@hg.vhebron.es
Rodríguez-Sinovas
A
A
Anivarro
I
I
Moure
C
C
Tresànchez
M
M
Soler-Soler
J
J
D000704:Analysis of Variance; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D000818:Animals; D001285:Atropine / Q000494:pharmacology; D001341:Autonomic Nervous System / Q000503:physiopathology*; D003327:Coronary Disease / Q000503:physiopathology* / Q000628:therapy; D004562:Electrocardiography; D005260:Female; D005725:Ganglia, Autonomic / Q000601:surgery; D005730:Ganglionic Blockers / Q000494:pharmacology; D006339:Heart Rate; D006439:Hemodynamics; D018738:Hexamethonium / Q000494:pharmacology; D008297:Male; D008954:Models, Biological; D018727:Muscarinic Antagonists / Q000494:pharmacology; D019800:Phenol / Q000494:pharmacology; D012815:Signal Processing, Computer-Assisted; D013552:Swine; D014628:Vagotomy; D017725:Ventricular Pressure
D005730:Ganglionic Blockers; D018727:Muscarinic Antagonists; D019800:Phenol; D018738:Hexamethonium; D001285:Atropine