Membrane physiological reactions of human arteriosclerotic coronary arteries to hypoxia

Hyperoxia does not directly affect vascular tone in isolated arteries from mice

Hospitalized patients often receive oxygen supplementation, which can lead to a supraphysiological oxygen tension (hyperoxia). Hyperoxia can have hemodynamic effects, including an increase in systemic vascular resistance. This increase suggests hyperoxia-induced vasoconstriction, yet reported direct effects of hyperoxia on vessel tone have been inconsistent. Furthermore, hyperoxia-induced changes in vessel diameter have not been studied in mice, currently the most used mammal model of disease. In this study we set out to develop a pressure-myograph model using isolated vessels from mice for investigation of pathways involved in hyperoxic vasoconstriction. Isolated conduit and resistance arteries (femoral artery and gracilis arteriole, respectively) from C57BL/6 mice were exposed to normoxia (PO₂ of 80 mmHg) and three levels of hyperoxia (PO₂ of 215, 375 and 665 mmHg) in a no-flow pressure myograph setup. Under the different PO₂ levels, dose-response agonist induced endothelium-dependent vasodilation (acetylcholine, arachidonic acid), endothelium-independent vasodilation (s-nitroprusside), as well as vasoconstriction (norepinephrine, prostaglandin F2α) were examined. The investigated arteries did not respond to oxygen by a change in vascular tone. In the dose-response studies, maximal responses and EC50 values to any of the aforementioned agonists were not affected by hyperoxia either. We conclude that arteries and arterioles from healthy mice are not intrinsically sensitive to hyperoxic conditions. The present ex-vivo model is therefore not suitable for further research into mechanisms of hyperoxic vasoconstriction.

Effect of Hypoxia-Reoxygenation on Endothelial Function in Porcine Cardiac Microveins

BACKGROUND

The cardiac venous system possesses up to 30% of total coronary vascular resistance and the effect of hypoxia-reoxygenation (H-R) and St Thomas (ST) cardioplegic solution on the vein is unknown. We investigated the effects of H-R, with or without ST, on endothelium-derived hyperpolarizing factor (EDHF)-mediated relaxation in porcine cardiac microveins under clinically relevant temperatures.

METHODS

The microveins (diameter 200 to 450 microM) mounted in a myograph were subjected to hypoxia (Po2 < 5 mm Hg) for 30 minutes in Krebs solution (n = 8) or for 60 minutes in Krebs (n = 8) or in ST at 37 degrees C (n = 8) or 4 degrees C (n = 8), followed by 30-minute reoxygenation. The microvein was precontracted with thromboxane A2 mimetic U46619 (-7 log M) and the EDHF-mediated relaxation was induced by bradykinin (-10 to -6 log M) in the presence of indomethacin, NG-nitro-L-arginine, and oxyhemoglobin before and after H-R.

RESULTS

The maximal EDHF-mediated relaxation was significantly reduced after 30-minute hypoxia (38.7 +/- 2.0% vs 61.1 +/- 2.3%, n = 8, p < 0.001) or 60-minute hypoxia in either Krebs or ST at 37 degrees C (Krebs: 27.8 +/- 1.2% vs 56.6 +/- 2.5%, n = 8, p < 0.001; ST: 23.8 +/- 4.1% vs 57.1 +/- 1.5%, n = 8, p < 0.001). The relaxation was significantly less after prolonged H-R in Krebs (p < 0.001). Incubation in Krebs or ST at 4 degrees C also reduced the EDHF-mediated relaxation (Krebs: 25.3 +/- 3.3%, n = 8, p < 0.001; ST: 29.1 +/- 4.4%, n = 8, p < 0.001) and there were no significant differences between Krebs and ST regarding the relaxation at either 37 degrees C or 4 degrees C (p > 0.05).

CONCLUSIONS

We conclude that (1) H-R impairs EDHF-mediated relaxation in the coronary microveins with more severe injury during prolonged H-R and (2) ST does not provide protection to the EDHF-mediated relaxation impaired by H-R at either 37 degrees C or 4 degrees C.

Augmented activity of adenosine triphosphate-sensitive K+ channels induced by droperidol in the rat aorta

Droperidol produces the inhibition of K+ channels in cardiac myocytes. However, the effects of droperidol on K+ channels have not been studied in blood vessels. Therefore, we designed the present study to determine whether droperidol modulates the activity of adenosine triphosphate (ATP)-sensitive K+ channels in vascular smooth muscle cells. Rat aortic rings without endothelium were suspended or used for isometric force and membrane potential recordings, respectively. Vasorelaxation and hyperpolarization induced by levcromakalim (10(-8) to 10(-5) M or 10(-5) M, respectively) were completely abolished by the ATP-sensitive K+ channel antagonist glibenclamide (10(-5) M). Droperidol (10(-7) M) and an alpha-adrenergic receptor antagonist phentolamine (3 x 10(-9) M) caused a similar vasodilator effect (approximately 20% of vasorelaxation compared with maximal vasorelaxation induced by papaverine [3 x 10(-4) M]), whereas glibenclamide did not alter vasorelaxation induced by droperidol. Droperidol (3 x 10(-8) M to 10(-7) M) augmented vasorelaxation and hyperpolarization produced by levcromakalim, whereas phentolamine (3 x 10(-9) M) did not alter this vasorelaxation. Glibenclamide (10(-5) M) abolished the vasodilating and hyperpolarizing effects of levcromakalim in the aorta treated with droperidol (10(-7) M). These results suggest that droperidol augments vasodilator activity via ATP-sensitive K+ channels. However, it is unlikely that this augmentation is mediated by the inhibition of alpha-adrenergic receptors in vascular smooth muscles.

Hypoxia-Reoxygenation, St. Thomas Cardioplegic Solution, and Nicorandil on Endothelium-derived Hyperpolarizing Factor in Coronary Microarteries

BACKGROUND

We investigated effects of hypoxia-reoxygenation (H-R) with and without St. Thomas solution under clinically relevant temperatures and effects of nicorandil on endothelium-derived hyperpolarizing factor (EDHF)-mediated relaxation in porcine coronary microarteries.

METHODS

In a myograph, rings of porcine microarteries (diameter 200 to 450 microm) were subjected to hypoxia (PO2 < 5 mm Hg) for 30 minutes in Krebs at 37 degrees C, or for 60 minutes in Krebs and St. Thomas solution with or without nicorandil (0.1 microM) at 37 degrees C or 4 degrees C, followed by 30-minute reoxygenation. The EDHF-mediated relaxation by bradykinin (-10 to approximately -6 logM) with inhibitors of nitric oxide and prostacyclin was studied.

RESULTS

The maximal EDHF-mediated relaxation was reduced after hypoxia for 30 minutes (59.9%% +/- 1.6% versus 81.2%% +/- 3.5%, p < 0.05) or 60 minutes (44.4% +/- 6.0% versus 82.7% +/- 7.4%, p < 0.001) in Krebs or St. Thomas (28.9% +/- 1.8% versus 78.1% +/- 3.0%, p < 0.001) at 37 degrees C and at 4 degrees C (Krebs: 49.3% +/- 3.0%, p < 0.001; ST: 43.1% +/- 2.6%, p < 0.001) and it was less in St. Thomas solution at 37 degrees C than at 4 degrees C (p < 0.001). The reduced relaxation was recovered by nicorandil (Krebs at 37 degrees C: 81.7% +/- 3.4%, p < 0.001; St. Thomas at 37 degrees C: 71.0% +/- 7.9%, p <0.001; St. Thomas at 4 degrees C: 85.3% +/- 3.3%, p < 0.001).

CONCLUSIONS

We conclude that (1) H-R impairs EDHF-mediated relaxation in the coronary microarteries with more injury during prolonged H-R, and this can be partially eliminated by St. Thomas at 4 degrees C but not at 37 degrees C; and (2) as an additive, nicorandil may fully restore EDHF-mediated endothelial function after prolonged H-R.

Endothelial Function Related to Vascular Tone in Cardiac Surgery

Vascular endothelium has multiple functions including regulating of vascular tone, preventing platelet aggregation, anti-proliferation, etc. An intact endothelial function is essential to the maintenance of an adequate vascular tone, to prevent platelet aggregation in the intimal surface of blood vessels, to prevent smooth muscle proliferation, and to prevent atherosclerosis. This review focuses on endothelial function related to the vascular tone in cardiac surgery. The review is composed by three sections. In the first section, normal endothelial function related to vascular tone is described. In the second section, coronary endothelial function related to cardiac arrest and cardioplegic exposure is reviewed. In the third section, the endothelial function in the coronary bypass grafts is summarised. It is particularly important to understand that coronary endothelial dysfunction may be one of the major causes of low perfusion of the myocardium after cardiac arrest or donor heart preservation. Further, endothelium plays a major role in the maintenance of vascular tone and in the long-term patency of CABG grafts. The characteristics of endothelium in arterial and venous grafts and the correlation to the long-term patency are now more understood. A number of methods have been suggested to protect endothelial function in either coronary circulation or in coronary artery bypass grafts during cardiac surgery but further investigations in this field are warranted.

Myocardial protection during cardiac surgery from the viewpoint of coronary endothelial function

1. During cardiac surgery, the heart is arrested and subject to ischaemia-reperfusion injury. 2. To protect the heart, cardioplegia is usually used to initially stop and then maintain the still condition of the heart, which not only facilitates the precise operation but, more importantly, minimizes the energy consumption of the heart during this period. 3. The ischaemia-reperfusion injury may involve both myocytes and coronary endothelium-smooth muscle and, therefore, the protection of the heart should also involve these two aspects. 4. Injury to the heart involves: (i) ischaemia-reperfusion injury to the myocytes and coronary circulation; and (ii) possible injury to the coronary circulation by cardioplegia due to its hyperkalaemic components. 5. Injury to the coronary circulation may involve both endothelium-derived nitric oxide (EDNO) and endothelium-derived hyperpolarizing factor (EDHF) mechanisms. The EDNO mechanism is susceptible to ischaemia-reperfusion, whereas the EDHF mechanism may be altered by hyperkalaemic cardioplegia. 6. To further protect the heart, supplemental therapy for EDNO and optimizing the components of cardioplegia to restore the EDHF mechanism may be important.

Prostaglandin endoperoxide-dependent vasospasm in bovine coronary arteries after nitration of prostacyclin synthase

In the present study we used a bioassay to study the effects of peroxynitrite (ONOO-) on angiotensin II (A-II)-triggered tension in isolated bovine coronary arteries in order to show the consequences of the previously reported PGI2-synthase inhibition by ONOO- in this model. The following results were obtained: 1. 1 micromol L(-1) ONOO- impaired A-II-induced vasorelaxation and caused a second long lasting constriction phase. Indomethacin (10(-5)M) prevented both effects. U51605, a dual blocker of PGI2-synthase and thromboxane (TX)A2-synthase mimicked the effects of ONOO-. 2. The selective TXA2/prostaglandin endoperoxide (PGH2) receptor antagonist SQ29548 antagonized the second vasoconstriction phase after ONOO- -treatment. Since a generation of TXA2 and 8-iso-prostaglandin F2alpha could be excluded a direct action of unmetabolized PGH2 on the TXA2/PGH2 receptor was postulated. 3. ONOO- dose-dependently inhibited the conversion of 14C-PGH2 into 6-keto-PGF1alpha in isolated bovine coronary arteries with an IC50-value of 100 nM. 4. Immunoprecipitation of 3-nitrotyrosine-containing proteins with a monoclonal antibody revealed PGI2-synthase as the only nitrated protein in bovine coronary arteries treated with 1 micromol 1(-1) ONOO-. 5. Using immunohistochemistry a co-localization of PGI2-synthase and nitrotyrosine-containing proteins was clearly visible in both endothelial and vascular smooth muscle cells. We concluded that ONOO- not only eliminated the vasodilatory, growth-inhibiting, antithrombotic and antiadhesive effects of PGI2 but also allowed and promoted an action of the potent vasoconstrictor, prothrombotic agent, growth promoter, and leukocyte adherer, PGH2.

Blood-flow sensing by anionic biopolymers

Using 23Na-NMR techniques we could show that the polyanion proteoheparan sulfate integrated into the membrane of endothelial cells may serve as "flow sensor'. Based on its viscoelastic properties, heparan sulfate proteoglycan is present as a random coil under "no flow' conditions, whereby most of its polyanionic sites undergo intramolecular hydrogen bonding. With increasing flow the macromolecule becomes unfolded into a filamentous structure. Additional anionic binding sites to which Na+ ions from the blood bind are released by this shear stress-dependent conformational change. The Na+ binding triggers the signal transduction chain for a vasodilatory vessel reaction. Decrease in flow effects, for reasons of the intramolecular elastic recoil forces of the macromolecules, an entropic coiling, the release of Na+ ions and thus an interruption of the signal chain. Proteoheparan sulfate adsorbed onto a hydrophobic surface in physiological Krebs solution at pH 7.3 demonstrated clearly its characteristic as a Na+ sensor. While Ca2+ ions modulated the adsorption (promotion with increasing Ca2+ concentrations) by changing the conformation of the sensor molecule, the adsorbed amount was determined preferably by the Na+ concentration. K+ and Mg2+ ions showed slightly desorbing properties with increasing concentrations. Thus, it may be concluded that Na+ ions play the role as "first messenger' in flow-dependent vasodilation.

Anionic biopolymers as blood flow sensors

The finding of flow-dependent vasodilation rests on the basic observation that with an increase in blood flow the vessels become wider, with a decrease the vascular smooth muscle cells contract. Proteoheparan sulphate could be the sensor macromolecule at the endothelial cell membrane-blood interface, that reacts on the shear stress generated by the flowing blood, and that informs and regulates the vascular smooth muscle cells via a signal transduction chain. This anionic biopolyelectrolyte possesses viscoelastic and specific ion binding properties which allow a change of its configuration in dependence on shear stress and electrostatic charge density. The blood flow sensor undergoes a conformational transition from a random coil to an extended filamentous state with increasing flow, whereby Na+ ions from the blood are bound. Owing to the intramolecular elastic recoil forces of proteoheparan sulphate the slowing of a flow rate causes an entropic coiling, the expulsion of Na+ ions and thus an interruption of the signal chain. Under physiological conditions, the conformation and Na+ binding proved to be extremely Ca(2+)-sensitive while K+ and Mg2+ ions play a minor role for the susceptibility of the sensor. Via counterion migration of the bound Na+ ions along the sensor glycosaminoglycan side chains and following Na+ passage through an unspecific ion channel in the endothelial cell membrane, the signal transduction chain leads to a membrane depolarization with Ca2+ influx into the cells. This stimulates the EDRF/NO production and release from the endothelial cells. The consequence is vasodilation.

Vasoconstrictor and vasodilator effects of hypoxia

Hypoxia has marked effects on artery calibre, which reflects important physiological control mechanisms that are altered in disease states. Hypoxia modifies the release of mediators, especially from the endothelium, and influences smooth muscle membrane potential and Ca2+ regulation. In this review, Roger Wadsworth evaluates the vasoconstrictor and vasodilator effects of hypoxia studied in vitro. In the future, drugs developed to act on the mediators or smooth muscle may be beneficial in the therapy of, for example, pulmonary hypertension or coronary vasospasm.