The Journal of Thoracic and Cardiovascular Surgery, Vol 99, 75-81, Copyright © 1990 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association
Beta-adrenergic receptor changes during coronary artery bypass grafting
J Mantz, J Marty, Y Pansard, D Henzel, A Loiseau, M Pocidalo, J Langlois and JM Desmonts
Department of Anesthesiology, INSERM U 82, Paris, France.
To evaluate whether the function of beta-adrenergic receptors, essential to
the biologic activity of catecholamines, is altered during coronary artery
bypass grafting, we measured, in 16 patients undergoing myocardial
revascularization, the density and the affinity of lymphocyte
beta-adrenergic receptors before anesthesia induction (control) and at the
end of cardiopulmonary bypass. Variations in the density and affinity of
beta-adrenergic receptors were determined in vitro. Repeated determinations
of plasma epinephrine and norepinephrine concentrations were also
performed. Overall, no significant modification was observed in mean
density and affinity of beta- adrenergic receptors at the end of
cardiopulmonary bypass when compared with control values. However, a
significant decrease (p less than 0.05) in affinity for isoproterenol was
found in the six patients who had high catecholamine levels during
cardiopulmonary bypass. In contrast, no significant modification of
beta-adrenoreceptor affinity for isoproterenol was observed in the 10
patients who did not have this degree of adrenergic activation. In
addition, beta-adrenoreceptor affinity for isoproterenol was decreased in
the three patients in whom intraaortic balloon pumping was mandatory after
discontinuation of cardiopulmonary bypass. We suggest that this decreased
affinity of lymphocyte beta-adrenergic receptors could be related, at least
in part, to a sustained adrenergic activation occurring in some patients
during cardiopulmonary bypass.
