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CARDIOVASCULAR ANESTHESIA

The Cardiac Effects of Intracoronary Angiotensin II Infusion

Department of Surgical and Perioperative Science, Anaesthesiology and Intensive Care, Umeå University Hospital, Umeå, Sweden

Address correspondence and reprint requests to Michael Broomé, Department of Cardiothoracic Surgery and Anesthesia, Huddinge University Hospital, S-141 86 Stockholm, Sweden. Address e-mail to michael.broome{at}thsurg.hs.sll.se

Angiotensin II (Ang II) is a potent vasoconstrictor, which recently has been shown to also have significant inotropic effects. Previous results regarding the mechanisms of the acute inotropic effects of Ang II are not conclusive. We designed this study to investigate the local cardiac effects of intracoronary Ang II infusion in doses not affecting systemic circulation. Ang II (2.5–40 µg/h) was infused in the left coronary artery of Yorkshire pigs (n = 9) reaching calculated intracoronary Ang II concentrations of 842 ± 310, 3342 ± 1238, and 12448 ± 4393 pg/mL, respectively. Cardiac systolic and diastolic function was evaluated by analysis of the left ventricular pressure-volume relationship. Coronary flow was measured by using a coronary sinus catheter and the retrograde thermodilution technique. No significant changes were seen in the systolic and diastolic function variables of heart rate, end-systolic elastance, preload recruitable stroke work, the time constant for isovolumetric relaxation, or in coronary vascular resistance and flow. The positive inotropic and chronotropic effects of Ang II seen in previous studies seem thus to be mediated via extracardiac actions of Ang II. Coronary vascular tone is not affected by local Ang II infusion in anesthetized pigs.

IMPLICATIONS: The positive inotropic and chronotropic effects of angiotension II (Ang II) seen in previous studies seem to be mediated via extracardiac actions of Ang II. Coronary vascular tone is not affected by local Ang II infusion in anesthetized pigs.

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