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Anesth Analg 1988; 67:514-520
© 1988 International Anesthesia Research Society
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Mechanisms of Enhanced Canine Subendocardial Perfusion

A Comparison of Adenosine Triphosphate and Sodium Nitroprusside

Lorie R. Pelc, PhD, Garrett J. Gross, PhD, John P. Kampine, MD, PhD, and David C. Warltier, MD, PhD

Departments of Pharmacology, Medicine, and Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin, and the Veterans Administration Medical Center, Wood, Wisconsin.

Abstract

The purpose of these experiments was to determine the effects of adenosine triphosphate (ATP) and sodium nitroprusside, two compounds used to produce controlled hypotension during surgery, on regional myocardial blood flow. Intracoronary drug infusions in open chest, anesthetized dogswere used to study the direct actions of these agents on the coronary circulation as well as to avoid systemic hemodynamic effects. The actions of the endothelium-dependent and -independent vasodilators, ATP and nitroprusside, respectively, were studied before and after administration ofquinacrine (an inhibitor of phospholipase A2), which blocks formation and/or release ofendothelium-derived relaxing factor (EDRF). Both vasodilators produced significant increases in transmural blood flow of the drug-perfused zone. Only ATP, the endothelium-dependent vasodilator, altered the distribution of myocardial blood flow. Perfusion to the subendocardium was preferentially increased by ATP, resulting in an increase in the subendocardial-to-subepicardial flow ratio. Quinacrine markedly inhibited the increase in endolepi produced by ATP without changing total flow. These data suggest that ATP increases total coronary blood flow by a mechanism that isindependent of EDRF, but the selective redistribution of blood flow to the subendocardium is dependent on EDRF. Nitroprusside, an endothelium-independent vasodilator, produces no redistribution of myocardial blood flow.

Key Words: ANESTHETIC TECHNIQUES, HYPOTENSIVE—ATP • HEART, CORONARY BLOOD FLOW—Oxygenation




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Lippincott, Williams & Wilkins Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999 HighWire Press
Copyright © 1988 by the International Anesthesia Research Society.