In Vitro Effects of Dopamine on Internal Thoracic Artery Graft Used in Coronary Artery Bypass Surger

Abstract

Objective: The aim of this study was to investigate in vitro effects of dopamine on internal thoracic artery (ITA) graft. Material and Methods: Between December 2003- June 2005, 32 patients (2 women and 30 men, mean age; 59.26±8.34, range 37-75 years old) who were subjected to coronary artery bypass grafting (CABG) operation in our clinic were enrolled in this study. ITA remnants were suspended in an isolated organ bath. Constrictor or relaxant responses to dopamine were recorded isometrically. Results: Dopamine in the concentration range of 10-9 M-10-7 M produced a mild relaxant effect on phenylephrine-precontracted ITA, and at higher concentrations than 10-7 M it produced a constrictor response. Ther relaxant effect of dopamine was partially antagonized by L-NAME (nitric oxide synthase inhibitor, 10-6 M), propranolol (10-6 M), and cis-α-flupenthixol (dopaminergic receptor antagonist, 10-6 M), but not by metoclopramide (D2-dopaminergic receptor antagonist). The constrictor effect of dopamine was partially antagonized by phentolamine, prazosin and, yohimbine. Conclusion: It was concluded that, while dopamine produces a vasodilator response at the lower concentrations, it causes a constrictor effect on ITA at the higher concentrations. Both a β-adrenergic and a nitric oxide mediated mechanism (via D1-dopaminergic receptor) may play a role in the relaxant effect of dopamine on ITA at the lower concentrations. Constrictor response to dopamine at the higher concentrations on ITA may be produced by the activation of α1- and α2-adrenergic receptors. Turkish Başlık: Dopaminin Koroner Arter Bypass Cerrahisi Operasyonlarında Kullanılan İnternal Torasik Arter Grefti Üzerine İn Vitro Etkileri Anahtar Kelimeler: İnternal torasik arter; koroner arter bypass cerrahisi; dopamin Amaç: Bu çalışmanın amacı dopaminin internal torasik arter (İTA) grefti üzerine etkilerini, invitro araştırmaktır. Gereç ve Yöntemler: Aralık 2003- Haziran 2005 tarihleri arasında kliniğimizde koroner arter bypass greft (CABG) operasyonu olan toplam 32 hasta (2'si kadın 30'u erkek, ortalama yaş; 59.256±8,.34, 37-75 yaşları arası) çalışmaya alındı. İn vitro organ banyosunda hastaların ITA'larından arta kalan parçacıklar üzerinde dopaminin oluşturduğu kasıcı ve gevşetici yanıtlar isometrik olarak kaydedildi. Bulgular: Dopamin 10-9 M-10-7 M konsantrasyon aralığında fenilefrinle önceden kastırılmış ITA'da hafif bir gevşeme yanıtı, sonrasında artan konsantrasyonlarında (>10-7 M) kasılma yanıtı gerçekleştirdiği gözlendi. Dopaminin gevşetici etkisinin kısmen L-NAME (nitrik oksit sentaz inhibitorü, 10-6 M), propranolol (10-6 M) ve cis-α-flupentiksol (dopaminerjik reseptör antagonisti, 10-6 M) ile kısmen azaldığı fakat metoklopramidin (D2-dopaminerjik reseptör antagonisti) dopaminin kaynaklı gevşemeye etki yapmadığı gözlendi. Dopaminin ITA'daki kasıcı etkisi kısmen fentolamin, prazosin ve yohimbin ile antagonize edildiği gözlendi. Sonuç: Sonuç olarak dopamin düşük konsantrasyonlarda ITA'da vazodilatasyon yanıtını oluştururken daha yüksek konsantrasyonlarda ITA'da vasokonstriksiyon yanıtını oluşturmaktadır. β-adrenerjik ve nitrik oksit aracılı mekanizma (D1-dopaminerjik reseptör yoluyla) dopaminin düşük konsantrasyonlarında ITA'da oluşturduğu gevşetici etkide rol alabilir. Dopaminin yüksek konsantrasyonlardaki ITA'da oluşturduğu kasıcı etki α1- ve α2-adrenerjik reseptörlerin aktivasyonu ile oluşturulmaktadır.

Keywords

• Internal thoracic artery; coronary artery bypass surgery; dopamine

Dopaminin Koroner Arter Bypass Cerrahisi Operasyonlar×nda Kullan×lan únternal Torasik Arter Grefti Üzerine ún Vitro Etkileri

Öz

Amaç: Bu çal×üman×n amac× dopaminin internal torasik arter (úTA) grefti üzerine etkilerini, invitro araüt×rmakt×r. Gereç ve Yöntemler: Aral×k 2003- Haziran 2005 tarihleri aras×nda kliniùimizde koroner arter bypass greft (CABG) operasyonu olan toplam 32 hasta (2’si kad×n 30’u erkek, ortalama yaü; 59.256±8,.34, 37-75 yaülar× aras×) çal×ümaya al×nd×. ún vitro organ banyosunda hastalar×n ITA’lar×ndan arta kalan parçac×klar üzerinde dopaminin oluüturduùu kas×c× ve gevüetici yan×tlar isometrik olarak kaydedildi. Bulgular: Dopamin 10-9 M-10-7 M konsantrasyon aral×ù×nda fenilefrinle önceden kast×r×lm×ü ITA’da hafif bir gevüeme yan×t×, sonras×nda artan konsantrasyonlar×nda (>10-7 M) kas×lma yan×t× gerçekleütirdiùi gözlendi. Dopaminin gevüetici etkisinin k×smen L-NAME (nitrik oksit sentaz inhibitorü, 10-6 M), propranolol (10-6 M) ve cis-њ-flupentiksol (dopaminerjik reseptör antagonisti, 10-6 M) ile k×smen azald×ù× fakat metoklopramidin (D2-dopaminerjik reseptör antagonisti) dopaminin kaynakl× gevüemeye etki yapmad×ù× gözlendi. Dopaminin ITA’daki kas×c× etkisi k×smen fentolamin, prazosin ve yohimbin ile antagonize edildiùi gözlendi. Sonuç: Sonuç olarak dopamin düüük konsantrasyonlarda ITA’da vazodilatasyon yan×t×n× oluütururken daha yüksek konsantrasyonlarda ITA’da vasokonstriksiyon yan×t×n× oluüturmaktad×r. ћ-adrenerjik ve nitrik oksit arac×l× mekanizma (D1-dopaminerjik reseptör yoluyla) dopaminin düüük konsantrasyonlar×nda ITA’da oluüturduùu gevüetici etkide rol alabilir. Dopaminin yüksek konsantrasyonlardaki ITA’da oluüturduùu kas×c× etki њ1- ve њ2-adrenerjik reseptörlerin aktivasyonu ile oluüturulmaktad×r.

Anahtar Kelimeler

• Internal torasik arter, koroner arter bypass cerrahisi, dopamin

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