Effects of stretch or distention on phenylephrine-induced constriction of human coronary artery bypass grafts.
OBJECTIVE
To determine the effects of grafting saphenous veins into the arterial circulation and to compare the responsiveness of saphenous veins and mammary arteries to vasoconstrictors (phenylephrine or potassium) and a vasodilator (the calcium antagonist isradipine).


METHODS
Prospective, controlled, in vitro study.


METHODS
Laboratory facility in a university teaching hospital.


METHODS
Small excess segments of internal mammary arteries or saphenous veins obtained from patients undergoing coronary artery bypass graft surgery.


METHODS
Vessel segments were cut into rings to measure isometric tension development in isolated tissue chambers. The law of LaPlace for a cylinder was applied to determine tensions in vitro corresponding with arterial or venous tensions in vivo or distending pressures ex vivo.


RESULTS
Stretching saphenous vein rings from venous to arterial tensions reduced maximal phenylephrine-induced constriction but did not alter their dose response to phenylephrine, potassium, or isradipine. At arterial tensions, potassium, but not phenylephrine, was more potent in constricting mammary artery than saphenous vein; isradipine was more potent as a vasodilator of potassium-constricted mammary artery than saphenous vein. Maximal phenylephrine-induced or potassium-induced constriction was no different for either vessel at arterial tensions; however, prior distention of veins to tensions corresponding with pressures of 200 or 300 mmHg significantly (p < 0.01, Dunnett's test) reduced subsequent constriction.


CONCLUSIONS
Phenylephrine may be more likely to constrict native internal mammary arteries than distended autogenous saphenous vein grafts in vivo because high-pressure distention of veins markedly inhibits their vasoreactivity.
Wendling
W W
WW
Department of Anesthesiology, Section of Cardiac and Thoracic Surgery, Temple University Hospital, 3401 North Broad Street, Philadelphia, PA 19140, USA..
Krasner
L J
LJ
Cooper
S C
SC
Chen
D
D
Harakal
C
C
Addonizio
V P
VP
Brister
N W
NW
Carlsson
C
C
D001026:Coronary Artery Bypass; D004305:Dose-Response Relationship, Drug; D006801:Humans; D066298:In Vitro Techniques; D017275:Isradipine / Q000494:pharmacology; D008323:Mammary Arteries / Q000187:drug effects* / Q000502:physiology / Q000637:transplantation; D010656:Phenylephrine / Q000494:pharmacology*; D011188:Potassium / Q000494:pharmacology; D012501:Saphenous Vein / Q000187:drug effects* / Q000502:physiology / Q000637:transplantation; D013314:Stress, Mechanical; D014661:Vasoconstriction / Q000187:drug effects / Q000502:physiology*; D014662:Vasoconstrictor Agents / Q000494:pharmacology*; D014665:Vasodilator Agents / Q000494:pharmacology
D014662:Vasoconstrictor Agents; D014665:Vasodilator Agents; D010656:Phenylephrine; D011188:Potassium; D017275:Isradipine