Ventricular sensory endings mediate reflex bradycardia during coronary arteriography in humans

Circulation
J A ArrowoodM D Thames

Abstract

It has been suggested that the response to the intracoronary injection of radiographic contrast is reflex in origin and results from stimulation of ventricular sensory endings. Cardiac transplantation results in denervation of the ventricles, and thus, may interrupt the afferent limb of this reflex. In contrast, the recipient sinus node and atrial remnant remain innervated, leaving the efferent cardiac limb of this reflex intact. We hypothesized that if contrast-induced reflex bradycardia and hypotension occurred from stimulation of ventricular chemosensitive endings, then this response would be abolished after cardiac transplantation. To test this hypothesis, we determined the changes in recipient (innervated) and donor (denervated) sinus-node rates (SNR) and mean arterial pressure during selective right (RCA) and left coronary artery (LCA) injection during arteriography in cardiac transplant patients and in patients with intact cardiac innervation. An increase in the recipient SNR was observed in cardiac transplant patients during left and right coronary injections (LCA, 6.6 +/- 1.7 beats/min; RCA, 2.4 +/- 1.4 beats/min) compared with a decrease in the control subjects (LCA, -15.3 +/- 2.3 beats/min; RCA, -6.9 +/- 1.9 beats/mi...Continue Reading

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Citations

May 1, 1994·Journal of Clinical Pharmacology·M L Smith
Apr 1, 1993·Journal of the American College of Cardiology·M B WaxmanR W Wald
Oct 1, 1993·Journal of the American College of Cardiology·M D ThamesM E Dibner-Dunlap
Sep 13, 1990·The New England Journal of Medicine·U ScherrerR G Victor
Sep 28, 2001·British Journal of Anaesthesia·S M Kinsella, J P Tuckey
Apr 30, 2003·Anesthesiology·Jason A Campagna, Christopher Carter
Jun 1, 1991·Medical Hypotheses·D F DavilaO Rossell
May 1, 1997·Current Problems in Cardiology·M C Henderson, S D Prabhu
Mar 1, 1990·The New England Journal of Medicine·U ScherrerR G Victor

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