Coronary constriction induced by vagal stimulation in the isolated rat heart

Vagally mediated multivessel coronary artery spasm during coronary angiography

We report on a case of multivessel coronary artery spasm preceded by vagal signs and symptoms, which resolved after administration of atropine. This supports that the spasm was triggered by endogenous acetylcholine.

Opposing actions of cholinergic agonist and trinitroglycerin on net vascular resistance in perfused rat heart

The effects of cholinergic agonist and nitrovasodilator on transorgan pressure-flow relationships were characterized under antegrade aortic perfusion of the rat heart. Under basal conditions, the preparation exhibited a stable linear dependence of perfusion pressure upon regulated transorgan flow rate from 0 to 9 ml/min with a transorgan vascular resistance of 5 +/- 0.6 mmHg/ml per min. Maximal acetyl-beta-methacholine (10 microM) caused a 3-fold increase in net transorgan vascular resistance to flow of non-cellular perfusate as observed over the range of constant flow rates from 1 to 8 ml/min. Trinitroglycerin (20 microM) reversed cholinergic-induced vasoconstriction. The effects of acetylcholine on transorgan flow were characterized at constant perfusion pressures approximating mean aortic pressures under lethal hypotension (40 mmHg), sublethal hypotension (70 mmHg) and normotension (100 mmHg). Under maximal acetylcholine (5 microM), flow remained adequate at 4.6 ml/min under 100 mmHg aortic pressure, marginally adequate at 1.2 ml/min under 70 mmHg, and sublethally inadequate at 0.4 ml/min under 40 mmHg. It is concluded that acetylcholine is among the factors increasing vascular resistance that can be opposed by nitrovasodilator. It is estimated that inadequate flow might result from maximal cholinergic agonist under hypotensive but apparently not normotensive aortic perfusion pressure as observed in hearts from normal animals.

Spinal anesthesia attenuates myocardial ischemia during coronary artery spasm induced by intraaortic methacholine in rats

Coronary artery spasm is not rare in patients with coronary artery disease, but the influence of regional anesthesia on spasm-induced myocardial ischemia is not known. We investigated the effects of spinal anesthesia on myocardial ischemia during coronary artery spasm in rats, and compared these with the effects of an alpha- and beta-adrenergic antagonist, and an alpha-adrenergic agonist. An intraaortic catheter was inserted via the right internal carotid artery so that the tip of the catheter was placed near the coronary ostium. An intrathecal catheter was placed at lumbar level. Coronary spasm was induced by the intraaortic injection of methacholine, and we identified the thresholds of myocardial ischemia, defined as the dose of methacholine that induced ST-segment elevation. Subsequently, the thresholds were determined after spinal anesthesia, and after the intraaortic injection of phentolamine and propranolol. The thresholds of myocardial ischemia increased significantly after intrathecal bupivacaine. In contrast, the threshold did not change after the injection of phentolamine. The thresholds increased significantly after the injection of propranolol. Methoxamine significantly decreased the threshold of ischemia. These results demonstrated that spinal anesthesia attenuated myocardial ischemia during methacholine-induced coronary spasm. This effect was equivalent to that of propranolol.

Heterogeneity of muscarinic receptors in lamb isolated coronary resistance arteries

1. In vitro experiments in a microvascular myograph were designed to characterize postjunctional muscarinic receptors producing contraction both in the presence and absence of the endothelium in coronary resistance arteries (normalized diameter of 150-450 microns), isolated from the left ventricle of hearts from 3-6 month old lambs. Preferential muscarinic receptor antagonists were used to determine the receptor subtype: pirenzepine (M1 receptor), AFDX 116 (M2 receptor), 4-DAMP and pFHHSiD (M3 receptor). 2. The rank order of potency for muscarinic agonist-induced increases in tension in endothelium-intact preparations was oxotremorine-M = methacholine = acetylcholine (ACh) > carbachol. Removal of the endothelium increased the potency of ACh, but this procedure did not change either the sensitivity or maximal response to carbachol. 3. The contractile response to ACh was reproducible. Incubation with 3 x 10(-7)-3 x 10(-6) M pirenzepine induced non-parallel rightward shifts and depressed the maximum of the concentration-response curve to ACh in endothelium-intact arteries. The slope by Schild analysis was 2.9 +/- 0.8 (P < 0.05, n = 7). Atropine, AFDX 116, 4-DAMP and pFHHSiD produced parallel rightward shifts of the curves to ACh and the slopes of the Schild plots were not significantly different from unity. The pKB values for the antagonists from plots constrained to unity in endothelium-intact segments were: atropine (9.4), 4-DAMP (9.0), pFHHSiD (7.9) and AFDX 116 (6.2). 4. In endothelium-denuded arteries, pirenzepine, AFDX 116 and pFHHSiD caused concentration-dependent, parallel rightward displacements of the concentration-response curves to ACh and the slopes of the Schild plots were not significantly different from unity. The plots constrained to a slope of unity gave the following pKB values: pFHHSiD (8.7), pirenzepine (7.5) and AFDX 116 (6.2). 5. In the presence of the endothelium, low concentrations of pirenzepine (10(-9)-10(-7) M) produced leftward shifts of the ACh concentration-response curves. This potentiating effect of pirenzepine was reversed by endothelial cell removal. In preparations precontracted with the thromboxane-mimetic, U46619, the putative M1-selective agonist, McN-A-343, induced a biphasic relaxation with log IC50 of 8.53 +/- 0.14 and 5.02 +/- 0.08 for the first and second phase of the relaxation, respectively, and maximal relaxations of 22.8 +/- 4.3% and 41.1 +/- 5.4% (n = 16). McN-A-343 relaxed the vessels in the presence of 10(-7) M pFHHSiD and 3 x 10(-7) M AFDX 116, but not after incubation with 10(-9) M pirenzepine. 6. It is concluded from the pKB values for the antagonists used, that contraction induced by ACh in lamb coronary resistance arteries, in either the presence or the absence of the endothelium, is mediated via the M3 subtype of muscarinic receptors, while muscarinic receptors of another subtype at the endothelium seem to modulate the contractile response to ACh.

Characterization of muscarinic receptors mediating endothelium-dependent relaxation of bovine coronary artery

In order to identify the receptor subtype responsible for acetylcholine (ACh)-induced relaxation of bovine coronary artery, we determined the affinity of six subtype-selective muscarinic antagonists and compared them with affinity estimates obtained for bovine left atria. At low concentrations, ACh potently relaxed circular strips of coronary artery with endothelium (EC50 0.15 microM), but contracted them at higher agonist concentrations with potencies that depended on the presence or absence of endothelium: EC50 1.8 microM (without endothelium); 4.6 microM (with endothelium). The pA2 values obtained for antagonism of relaxant responses to ACh were: pirenzepine (M1-selective) 7.38 +/- 0.12; AF-DX 116 (11-[2-(diethylamino-methyl)-1-piperidinyl-acetyl]-5,11- dihydro-6H-pyrido(2,3-b)1,4-benzodiazepine-6-one; M2-selective) 5.79 +/- 0.09; and 4-diphenylacetoxy-N-methyl-piperidine-methobromide (4-DAMP; M3/M1-selective) 9.07 +/- 0.12. The corresponding Schild slopes were 0.98 +/- 0.07 for pirenzepine, 1.17 +/- 0.09 for AF-DX 116 and 1.01 +/- 0.04 for 4-DAMP. For the following three antagonists, pKB values were determined at two different antagonist concentrations: dicyclomine (M1-selective) 7.49 +/- 0.10, cyclohexylphenyl-(2-piperidinoethyl)-silanol (CPPS; M3-selective) 8.0 +/- 0.10, and parafluoro-hexahydrosila-difenidol (pFHHSiD; M3-selective) 7.87 +/- 0.10. For comparison, the antagonism of methacholine-induced negative inotropy in left atria was determined for three antagonists, yielding the following pA2 values: pirenzepine 5.98 +/- 0.14; AF-DX 116 6.81 +/- 0.14 and 4-DAMP 7.99 +/- 0.14. The slopes of the corresponding Schild plots were 1.05 +/- 0.10, 1.14 +/- 0.12 and 1.08 +/- 0.08, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Evidence for muscarinic receptors in endothelial cells from combined functional and binding studies

The aim of this study was to characterize muscarinic receptors of the bovine coronary artery by means of a combination of mechanical relaxation and contraction responses and radioligand binding data. Fresh helical strips of bovine coronary artery with intact endothelium relaxed in response to low concentrations (0.03-1 microM) of acetylcholine (ACh) and contracted at higher concentrations while endothelium-denuded strips only contracted. The ED50 for relaxation was 0.13 microM and that for contraction 1.8 microM (without endothelium); in the presence of endothelium, contraction dose-response curves were shifted to the right and the maximum contraction was reduced. In order to determine the location of the receptors mediating vasorelaxation, apparent affinity constants (KA) of ACh for relaxant and contractile effects were determined by irreversible blockade of a fraction of receptors with propyl benzilylcholine mustard (PBCM). The affinity constants (KA) were 0.22 microM for relaxation and 13 microM (with endothelium) and 20 microM (without endothelium) for contraction. In competition binding experiments against the muscarinic antagonist, [3H]N-methylscopolamine ([3H]NMS), the apparent affinity (KI) of ACh for binding sites in homogenates of endothelium-free coronary artery was 16 microM which was not different from the affinity constant determined in functional contraction experiments. Thus, the affinity constant of ACh determined for relaxation responses with endothelium-preserved vessels had no correlate in the binding affinity as determined with endothelium-free arteries. These findings indicate that bovine coronary arteries are relaxed by ACh through muscarinic receptors located on the endothelium whereas contractions are mediated by receptors on smooth muscle cells.

Heterogeneity of vascular muscarinic receptors

Muscarinic receptors mediate diverse effects on the vasculature. Recently, a consensus has been arrived at with regard to muscarinic receptor classification (Levine & Birdsall, 1989). As a result, it may now be possible to clarify the role of each subtype in the responses of vascular tissues to muscarinic agonists. It is apparent that vascular muscarinic receptors form a heterogeneous population. M1 receptors contract canine venous tissue, whilst M3 receptors contract porcine and bovine coronary arteries. M3 receptors also mediate EDRF-dependent relaxant responses in the majority of tissues studied to date. M2 receptors elicit relaxations by a decrease in sympathetic outflow in canine femoral vein, rabbit ear artery and rat portal vein. These conclusions are primarily derived from functional estimations of equilibrium dissociation constants, since comparable radioligand binding data are both scarce and contradictory. It is concluded that all three major subtypes of receptors are present in the vasculature. However, the limited selectivity of the available antagonists, the lack of extensive use of such compounds and the unavailability of selective agonists clearly indicate the need for more definitive studies to be undertaken.

Nicorandil: animal pharmacology

Nicorandil, a nicotinamide derivative, is a recently developed, orally active antianginal drug with a cardioprotective activity, and its pharmacologic properties differ from those of conventional antianginal drugs. Nicorandil has the capacity to increase myocardial oxygen supply without increasing oxygen demand by reduction in preload and afterload. In isolated blood-perfused canine heart preparations, when injected into the sinus node, the atrioventricular node or the anterior septal arteries, nicorandil at dose levels doubling blood flow through the respective arteries has virtually no effect on sinus rate, atrioventricular conduction time or contractile force of ventricular muscle. This may indicate that nicorandil possesses a selective effect on the coronary vasculature rather than on the myocardium. Furthermore, the vasospasmolytic activity of nicorandil has been evidenced in in vivo and in vitro experiments. The precise mechanism by which nicorandil develops coronary vasodilating and vasospasmolytic effects remains to be elucidated, but it may be partly inferred by an increase in the potassium conductance in the membrane, a relation with cyclic guanosine monophosphate formation, or inhibition of intracellular calcium ion mobilization in the cell of coronary vascular smooth muscle. Nicorandil possesses a nitrate moiety in its chemical structure. However, it is noted that nicorandil unlike nitrates does not develop tolerance or cross tolerance to other conventional nitrates in terms of blood-pressure lowering effects and coronary vasodilating effects. Thus, nicorandil is likely to have highly beneficial properties in the treatment of angina pectoris.

Effects of perivascular nerve stimulation on the flow rate in isolated epicardial coronary arteries of pigs

The effect of perivascular nerve stimulation on coronary contraction was examined by perfusing the isolated epicardial coronary artery of pigs. Coronary flow decreased in a frequency-dependent manner after electrical stimulation, with a maximum percent flow reduction of 23.8 +/- 1.1% (n = 10) at 20 Hz. The reduction in flow rate was not inhibited by phentolamine nor propranolol but was inhibited by atropine. Neostigmine enhanced the flow reduction induced by nerve stimulation. Acetylcholine reduced the flow rate dose dependently but norepinephrine showed no effect. We conclude that perivascular nerve stimulation of the epicardial coronary artery of pigs causes a modest flow reduction through activation of a cholinergic mechanism.