HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Toyota, E. Articles by Kajiya, F. Search for Related Content PubMed PubMed Citation Articles by Toyota, E. Articles by Kajiya, F.

Ann Thorac Surg 1999;67:1254-1261
© 1999 The Society of Thoracic Surgeons

---

Original Articles

Endothelium-derived nitric oxide enhances the effect of intraaortic balloon pumping on diastolic coronary flow

^a Department of Systems Cardiology and Medical Engineering, Kawasaki Medical School, Okayama, Japan

Accepted for publication October 20, 1998.

Address reprint requests to Dr Toyota, Department of Systems Cardiology and Medical Engineering, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan
e-mail: toyota{at}me.kawasaki-m.ac.jp

Background. High shear rate with pulsation is one of the major stimuli for the release of endothelium-derived nitric oxide leading to coronary arteriolar dilation. Intraaortic balloon pumping mechanically enhances shear rate and diastolic-to-systolic flow oscillation. We aimed to evaluate whether or not coronary blood flow augmentation during intraaortic balloon pumping is mediated by coronary arteriolar dilation through endothelium-derived nitric oxide release.

Methods. Using a charge-coupled device intravital videomicroscope, we observed epicardial coronary arterioles (40 to 220 µm in diameter) in anesthetized open-chest dogs (n = 10) during 2:1 mode of intraaortic balloon pumping. Endothelium-derived nitric oxide-mediated vasodilatory effects of intraaortic balloon pumping were evaluated by comparing end-diastolic arteriolar diameters between the coupled beats of on and off intraaortic balloon pumping before and after intracoronary endothelium-derived nitric oxide synthesis inhibition with N-nitro-L-arginine (L-NNA, 2 µmol/min) administration.

Results. Intraaortic balloon pumping increased coronary arteriolar diameters and coronary blood flow by 11.4% ± 1.8% (p < 0.0001) and 33.4% ± 4.1% (p < 0.001), respectively. Vasodilation was greater in small arterioles (<110 µm; 15.4% ± 2.2%) than in large arterioles (110 µm; 4.2% ± 1.2%, p < 0.0001). L-NNA attenuated the intraaortic balloon pumping-induced vasodilation and augmentation of coronary blood flow to 4.6% ± 1.0% (p < 0.001) and to 20.8% ± 2.1%, (p < 0.05), respectively. Attenuation of vasodilatory effect by L-NNA was observed mainly in small arterioles (from 15.4% ± 2.2% to 5.9% ± 1.2%).

Conclusions. Intraaortic balloon pumping augmented coronary blood flow by dilating coronary arterioles in diastole, more significantly in small arterioles than in large arterioles. Endothelium-derived nitric oxide inhibition markedly attenuated these effects. We conclude that, in a canine model, endothelium-derived nitric oxide contributes to mechanical enhancement of the coronary blood flow with diastolic arteriolar vasodilation during intraaortic balloon pumping.

This article has been cited by other articles:

				J. R. Filip and R. S. Dillon Treatment of End-Stage "Trash Feet" With the End-Diastolic Pneumatic Boot Angiology, May 1, 2008; 59(2): 214 - 219. [Abstract] [PDF]

				J. A. Adams, J. Bassuk, D. Wu, M. Grana, P. Kurlansky, and M. A. Sackner Periodic acceleration: effects on vasoactive, fibrinolytic, and coagulation factors J Appl Physiol, March 1, 2005; 98(3): 1083 - 1090. [Abstract] [Full Text] [PDF]