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Ann Thorac Surg 2007;83:126-132
© 2007 The Society of Thoracic Surgeons

Original Articles: Cardiovascular

Temperature Changes Stimulate Contraction in the Human Radial Artery and Affect Response to Vasoconstrictors

Aung Y. Oo, FRCS (CTh)a, Alan R. Conant, PhDa,*, Michael R. Chester, MRCP, MDb, Walid C. Dihmis, FRCS (CTh)a, Alec W.M. Simpson, DPhilc

a The Cardiothoracic Centre, University of Liverpool, Liverpool, United Kingdom
b The National Refractory Angina Centre, University of Liverpool, Liverpool, United Kingdom
c Department of Human Anatomy and Cell Biology, University of Liverpool, Liverpool, United Kingdom

Accepted for publication August 18, 2006.

* Address correspondence to Dr Conant, The Cardiothoracic Centre, Liverpool NHS Trust, Thomas Drive, Liverpool L14 3PE, UK. (Email: alan.conant{at}ctc.nhs.uk).

BACKGROUND: Radial artery conduits are increasingly used in coronary artery bypass grafting as an additional arterial graft to the internal thoracic artery. Their reactive nature remains a concern, often necessitating the routine use of topically applied vasodilators, such as glyceryl trinitrate, papaverine, phenoxybenzamine, or calcium channel antagonists, in theatre. During preparation prior to surgery and grafting, radial artery conduits are exposed to cooling and rewarming. We investigated how these temperature changes would affect radial artery contractility and how commonly used topical treatments might be used to prevent this.

METHODS: Human radial artery was obtained excess to surgery and arterial sections used in organ bath tension experiments or for the culture of smooth muscle cells from medial explants.

RESULTS: The radial artery responded to rapid cooling by the addition of 22°C buffer with contraction. Gradual cooling, over a 20 to 30 minute period, reduced basal tension and the response to potassium chloride (KCl) and noradrenaline. Subsequent rewarming from 22°C to 37°C reestablished contraction at precooled levels and led to an elevation of the basal tension. Increases in tension measured in the radial artery were paralleled by increases in intracellular calcium in smooth muscle cells. Contraction induced by rapid temperature changes could be blocked by glyceryl trinitrate but not by phenoxybenzamine. Papaverine and calcium channel blockers had only limited activity.

CONCLUSIONS: Temperature changes commonly encountered in theatre during the preparation of radial artery grafts are likely to cause contraction. If rapid temperature change cannot be avoided during graft preparation, then topically applied glyceryl trinitrate will block these responses.


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