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Ann Thorac Surg 1993;56:97-100
© 1993 The Society of Thoracic Surgeons

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Articles

Thromboxane A₂: An endothelium-derived vasoconstrictor in human internal mammary arteries

Thoracic and Cardiovascular Surgery, and Nuclear Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan, ROC

Accepted for publication September 30, 1992.

^_* Address reprint requests to Dr Lin, Thoracic and Cardiovascular Surgery, Chang Gung Memorial Hospital, 199, Tun-Hwa North Road, Taipei, Taiwan, ROC.

The internal mammary artery (IMA) has become the conduit of choice for coronary artery bypass grafting. However, the IMA graft can exhibit vasoconstriction during the perioperative period. Experiments were designed to determine the role of cyclooxygenase products in human IMA during hypoxia. Rings of IMA, with and without endothelium, were suspended in organ baths containing physiologic salt solution. Rings were contracted with norepinephrine and then exposed to hypoxia for 15 minutes. In segments with endothelium, hypoxia inducted a transient relaxation followed by contraction. This contraction was associated with a significantly increased production of thromboxane B₂, the stable metabolite of thromboxane A₂ (n = 10; from 120.7 ± 3.5 pg/mg wet tissue before hypoxia to 175.8 ± 5.2 pg/mg during hypoxia; p < 0.05). This hypoxic contraction could be attenuated by indomethacin. However, thromboxane B₂ could not be detected in samples from organ baths containing IMA segments without endothelium before or during hypoxia. This study demonstrated that endothelium of human IMA grafts releases thromboxane A₂ basally and that production is augmented by hypoxia, which acts to constrict the underlying vascular smooth muscle, increase vascular tone, and promote ischemic events such as vasospasm and thrombosis, particularly in hypoxemic patients.

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