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J Thorac Cardiovasc Surg 2004;128:609-614
© 2004 The American Association for Thoracic Surgery

Cardiopulmonary support and physiology

Effects of hydrostatic distention on in vitro vasoreactivity of radial artery conduits

^a Department of Cardiothoracic Surgery, Royal Brompton and Harefield NHS Trust, London, United Kingdom
^b Department of Cardiac Medicine, National Heart and Lung Institute at Imperial College of Science, Technology and Medicine, London, United Kingdom

Received for publication November 24, 2003; revisions received February 2, 2004; accepted for publication April 1, 2004.

^* Address for reprints: Chee Fui Chong, BSc, FRCS, Department of Cardiac, Thoracic and Vascular Surgery, National University Hospital, 5 Lower Kent Ridge Rd, Singapore 119074
chong_chee_fui{at}hotmail.com

BACKGROUND: Surgical preparation of coronary conduits may affect early and long-term patency through endothelial and smooth muscle injury. We investigated the effect of hydrostatic distention on the in vitro endothelial function and contractile properties of the human radial artery.

METHODS: Human radial arteries were harvested and distended to physiologic pressure or suprasystemic pressure (>300 mm Hg) by using heparinized whole blood for 2 minutes. Distal segments were retrieved and prepared into 3-mm rings. These were mounted and stretched to optimum resting tension in oxygenated Krebs solution at 37°C. Contraction responses to potassium, norepinephrine, and serotonin and relaxation responses to acetylcholine and nitroprusside were evaluated. Undistended radial artery segments were used as controls.

RESULTS: Vasocontraction to all 3 contractile agonists was significantly different between groups. The radial artery subjected to suprasystemic pressure distention achieved the lowest percentage of maximum contraction (potassium, P < .001; norepinephrine, P < .05; serotonin, P < .05). The median effective concentration was also significantly reduced in this group, indicating increased sensitivity to all 3 agonists. Receptor-mediated contractility was significantly reduced in both distended groups when compared with controls. Relaxation to acetylcholine and nitroprusside was significantly reduced in the suprasystemic pressure–distended group, which had a tendency to vasospasm when exposed to a physiologic concentration of acetylcholine (10^–6 mol/L). Median effective concentrations for both acetylcholine and nitroprusside were not different between groups.

CONCLUSIONS: Excessive distention of the radial artery leads to a significant reduction in vasoreactivity, which may be attributed to a disruption of the vascular endothelium and media, with a propensity for graft spasm with exposure to acetylcholine.

This article has been cited by other articles:

				P. Collins, C. M. Webb, C. F. Chong, N. E. Moat, and for the Radial Artery Versus Saphenous Vein Patenc Radial Artery Versus Saphenous Vein Patency Randomized Trial: Five-Year Angiographic Follow-Up Circulation, June 3, 2008; 117(22): 2859 - 2864. [Abstract] [Full Text] [PDF]