Document Detail

Role of cardiac sympathetic nerves in the genesis of myocardial ischemia distal to coronary stenoses.
MedLine Citation:
PMID:  2410728     Owner:  NLM     Status:  MEDLINE    
This manuscript summarizes the effects of cardiac sympathetic nerve activation on coronary blood flow and myocardial function, metabolism, and morphology distal to stenoses. Whereas cardiac sympathetic nerve activation induces an increase in myocardial function and metabolism accompanied by metabolic coronary dilation under physiological conditions, this response is different in the presence of coronary stenoses. With decreasing coronary hyperemic reserve, distal to an increasing degree of coronary stenosis, the predominant response to sympathetic stimulation is continuously shifted from metabolic dilation to alpha-adrenergic vasoconstriction. With a severe coronary stenosis, both electrical stimulation of cardiac sympathetic nerves and reflex sympathetic activation by carotid occlusion induce poststenotic vasoconstriction and ischemia of the dependent myocardium. Poststenotic vasoconstriction is mediated by vascular alpha 2-adrenoceptors and is prevented by phentolamine, rauwolscine, and nifedipine. Prolonged sympathetic activation even results in patchy subendocardial necroses. There is a vicious cycle between poststenotic vasoconstriction, myocardial ischemia, and cardiac sympathetic nerve activity that results in a progressive perfusion impairment during 20 min severe coronary stenosis.
G Heusch; A Deussen; J Schipke; H Vogelsang; V Hoffmann; V Thämer
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of cardiovascular pharmacology     Volume:  7 Suppl 5     ISSN:  0160-2446     ISO Abbreviation:  J. Cardiovasc. Pharmacol.     Publication Date:  1985  
Date Detail:
Created Date:  1985-09-06     Completed Date:  1985-09-06     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7902492     Medline TA:  J Cardiovasc Pharmacol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  S13-8     Citation Subset:  IM    
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MeSH Terms
Coronary Circulation / drug effects
Coronary Disease / etiology*,  pathology,  physiopathology
Heart / innervation*
Phentolamine / pharmacology
Propranolol / pharmacology
Sympathetic Nervous System / physiology*
Vascular Resistance / drug effects
Reg. No./Substance:
50-60-2/Phentolamine; 525-66-6/Propranolol

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

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