Circulation, Vol 85, 1473-1482, Copyright © 1992 by American Heart Association
YD Kim, JS Fomsgaard, KF Heim, PW Ramwell, G Thomas, E Kagan, SP Moore, SS Coughlin, M Kuwahara and A Analouei
BACKGROUND. Brief ischemic episodes that induce stunning of the myocardium
may also induce stunning of the coronary endothelium. To test this
hypothesis, we examined both in vivo and in vitro responses of canine
coronary arteries exposed to brief ischemia. METHODS AND RESULTS.
Functional recovery of the endothelium was examined in vivo during
reperfusion after 15 minutes of ischemia. Vasodilatory responses to
acetylcholine were severely impaired during the first hour of reperfusion
but gradually improved over a 90-minute period after ischemia. The
vasoconstrictive response to U46619 was enhanced for the first 30 minutes
of reperfusion and returned to normal within 60 minutes. In vitro vasomotor
responses to potassium chloride, acetylcholine, bradykinin, and sodium
nitroprusside were examined in isolated segments of canine coronary
arteries preexposed in vivo to brief ischemia (10-30 minutes) and 20
minutes of reperfusion. The results showed enhanced contractile responses
and blunted endothelium- dependent but not endothelium-independent
vasodilatory responses of arterial rings subjected to 10 minutes of
ischemia. Twenty and 30 minutes of ischemia completely impaired
endothelium-dependent vasodilation. When reperfusion was extended to 120
minutes after 15 minutes of ischemia, vasodilatory responses to
acetylcholine had recovered by almost 90%. Examination of endothelial
integrity by transmission electron microscopy after 10-15 minutes of
ischemia revealed no evidence of structural damage. Twenty and 30 minutes
of ischemia induced cytoplasmic vacuolation, partial detachment of
endothelium, and swelling of cytoplasmic organelles. CONCLUSIONS. These
data support the hypothesis that brief ischemia-reperfusion induces
stunning of endothelium in which endothelium-dependent vasodilatory
function is impaired temporarily without morphological damage.
ARTICLES
Brief ischemia-reperfusion induces stunning of endothelium in canine coronary artery
Department of Anesthesia, Georgetown University Medical Center, Washington, D.C.
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