Document Detail


Cardiac reflex effects of intracoronary bradykinin in humans.
MedLine Citation:
PMID:  8689412     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Endogenous production of bradykinin (BK) has been postulated to cause hemodynamic changes and cardiac pain during myocardial ischemia, presumably because of the stimulation of cardiac afferent fibers. METHODS: To test the hypothesis that BK results in cardiac reflex responses and can cause the sensation of angina, 10 patients with and without coronary atherosclerosis had BK injected into their right (RCA) and left (LCA) coronary arteries in graded concentrations up to 10(-5) m. Patients were monitored for hemodynamic changes and the presence and quality of pain. RESULTS: Intracoronary BK 10(-5) m caused a significant reduction in blood pressure in most patients with either injection into the RCA or LCA (RCA: 151 +/- 10/90 +/- 5 mm Hg to 119 +/- 11/70 +/- 6 mm Hg, LCA: 161 +/- 11/88 +/- 6 mm Hg to 118 +/- 10/65 +/- 6 mm Hg) that began 12 to 14 seconds after injection. Injection into the LCA also resulted in a significant increase in heart rate (69 +/- 4 to 81 +/- 7 beats/minute), while injection into the RCA did not. Pain occurred after changes in blood pressure in all but one patient, which was present in 5 of 9 patients with RCA injection and 8 of 9 patients with LCA injection, and was often associated with flushing and nausea. Pain caused by BK was not similar to previous clinical ischemic pain in the patients with coronary atherosclerosis. CONCLUSIONS: The absence of a chronotropic response associated with arterial hypotension following injection of BK into the RCA is consistent with activation of cardiac vagal afferents in the left ventricle. The latency and quality of pain in these patients following injection of BK suggests that, while BK is nociceptive, it likely is not the cause of angina in patients with myocardial ischemia.
Authors:
S Schaefer; R A Valente; L J Laslett; J C Longhurst
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of investigative medicine : the official publication of the American Federation for Clinical Research     Volume:  44     ISSN:  1081-5589     ISO Abbreviation:  J. Investig. Med.     Publication Date:  1996 Apr 
Date Detail:
Created Date:  1996-08-29     Completed Date:  1996-08-29     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9501229     Medline TA:  J Investig Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  160-7     Citation Subset:  IM    
Affiliation:
Division of Cardiovascular Medicine, University of California, Davis 95616, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Angina Pectoris / diagnosis,  physiopathology*
Blood Pressure / drug effects,  physiology
Bradykinin / diagnostic use,  physiology*
Coronary Artery Disease / diagnosis,  physiopathology
Coronary Circulation / drug effects,  physiology*
Coronary Disease / diagnosis,  physiopathology*
Electrocardiography / drug effects
Female
Heart Catheterization
Heart Rate / drug effects,  physiology
Hemodynamics / drug effects,  physiology*
Humans
Injections, Intra-Arterial
Male
Middle Aged
Vasoconstriction / drug effects,  physiology*
Chemical
Reg. No./Substance:
58-82-2/Bradykinin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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