Does spontaneous respiration alter pulmonary artery input impedance?

The aim of this study was to determine whether spontaneous respiration influences pulmonary artery input impedance, a question that has received little attention in the literature. Impedance values were assessed during three different phases of the respiratory cycle, namely inspiration, expiration and postexpiration (i.e. the null respiratory flow period between expiration and the next inspiration) in five anaesthetized spontaneously breathing dogs. Firstly, impedance values during postexpiration were taken as the reference baseline, and compared with values obtained during inspiration and expiration. Then, differences between values in inspiration and in expiration were tested, taking impedance during inspiration as the baseline. Differences with respect to postexpiration were found for three parameters of input impedance: input resistance, characteristic impedance, and the frequency at the first zero-crossing of the impedance phase from negative to positive values (f(cross)). Input resistance was significantly lower in inspiration (85% of the baseline), characteristic impedance was significantly greater in inspiration and in expiration (112 and 119% respectively), and f(cross) was significantly lower in expiration (89%). By contrast, only input resistance differed significantly when inspiration was compared to expiration. Therefore, spontaneous respiration was shown to influence input impedance significantly. The observed changes in characteristic impedance and f(cross) might be explained by a stiffening of the pulmonary artery wall, due to neural and/or mechanical factors, during inspiration and expiration.

Imidazol-1-yl and pyridin-3-yl derivatives of 4-phenyl-1,4-dihydropyridines combining Ca2+ antagonism and thromboxane A2 synthase inhibition.

A series of derivatives of 4-phenyl-1,4-dihydropyridine bearing imidazol-1-yl or pyridin-3-yl moieties on the phenyl ring were synthesized with the aim of combining Ca2+ antagonism and thromboxane A2 (TxA2) synthase inhibition in the same molecule. Some of these compounds showed significant combined Ca2+ antagonism and TxA2 synthase inhibition in vitro, while others showed only one single activity. Structural requirements for significant single or combined activities are discussed. Theoretical conformational analysis, by molecular mechanics and semiempirical AM1 calculations, was performed for 1,4-dihydro-2,6-dimethyl-4-[3-(1H-imidazol-1-yl)phenyl]- 3,5-pyridinedicarboxylic acid, diethyl ester (FCE 24265) and two close congeners. FCE 24265, which inhibited TxB2 production in rat whole blood with IC50 = 1.7 x 10(-7) M and antagonized K+ induced contraction in guinea pig aorta with IC50 = 6.0 x 10(-8) M, was selected for further pharmacological evaluation. Our results show that this compound is less potent than nifedipine both in vitro and in vivo yet presents a favorable profile in vivo, lowering blood pressure without inducing reflex tachycardia. Moreover, its additional potent and selective TxA2 synthase inhibitory activity makes this compound an interesting pharmacologic tool in pathologies where both enhanced TxA2 synthesis and cellular Ca2+ overload are involved.

Pharmacologic modulation of the autonomic nervous system in the prevention of sudden cardiac death. A study with propranolol, methacholine and oxotremorine in conscious dogs with a healed myocardial infarction.

OBJECTIVES: The goal of the present study was to evaluate the antifibrillatory and hemodynamic effects of pharmacologic muscarinic activation and to compare them with those of beta-adrenergic blockade. BACKGROUND: Recent studies suggest a correlation between increased vagal activity and a reduced incidence of sudden cardiac death. Electrical stimulation of the vagus nerve reduces the incidence of ventricular fibrillation in a conscious animal model of sudden cardiac death. METHODS: Eleven dogs with healed anterior myocardial infarction, in which a 2-min left circumflex coronary artery occlusion during exercise caused ventricular fibrillation, were studied. They underwent subsequent tests with saline solution, propranolol (1 mg/kg body weight), methacholine (0.5 microgram/kg per min) and oxotremorine (8 micrograms/kg). RESULTS: In the test with saline solution, 100% of the dogs developed ventricular fibrillation; this occurred in only 10% of the tests with propranolol (95% confidence interval 0.2% to 44%; p < 0.001), 60% of the tests with methacholine (95% confidence interval 26% to 88%, p = 0.05) and 37.5% of the tests with oxotremorine (95% confidence interval 8% to 75%, p = 0.005). Propranolol and oxotremorine significantly reduced heart rate compared with saline solution, whereas methacholine did not. Propranolol significantly reduced maximal first derivative of left ventricular pressure, (dP/dtmax), particularly during myocardial ischemia, compared with the other treatments (2,391 +/- 582 mm Hg/s [mean +/- 1 SD] with propranolol vs. 4,226 +/- 1,237, 4,922 +/- 584 and 4,358 +/- 1,109 mm Hg/s with saline solution, methacholine and oxotremorine, respectively, p < 0.005). CONCLUSIONS: Propranolol was extremely effective against ventricular fibrillation. Methacholine and oxotremorine provided a significant, although less marked, protection and caused much less impairment of contractility compared with propranolol. Muscarinic receptor activation may represent a new approach to prevention of sudden cardiac death, particularly when beta-blockers are contraindicated and negative inotropic effects are to be avoided.

[Which moments in the respiratory cycle have the most influence on right ventricular dynamics?]. / Quali momenti del ciclo respiratorio influiscono maggiormente sulla dinamica del ventricolo destro?

The performance of the right heart during respiratory activity has mostly been studied in terms of changes in flow and pressure in pulmonary circulation. The aim of this study was to identify which moments of the respiratory cycle exert the greatest influence on right ventricular dynamics. Thus, the behaviour of the right ventricular systolic time intervals and pulmonary artery pressures, expressed both as intravascular (Piv) and transmural (Ptm), were investigated to this end. Investigations were carried out on 10 anesthetized spontaneously breathing beagle dogs using high-fidelity pressure transducers (MPC 500, Millar Instr.) and by making use of a computerized system of signal recording and analysis. Changes in right ventricular systolic time intervals were evident during transition from inspiration to expiration and at the beginning of expiration. In fact, compared to spontaneous post-expiratory pause values, the so-called Rapid Ejection and Slow Ejection Phases, and therefore the Total Ejection Period, were significantly shortened (p less than 0.01 for both) only at early expiration, whereas during the same phase of the respiratory cycle the Isovolumetric Contraction Time and the total Pre-ejection Period were significantly prolonged (p less than 0.01 for both). During the transition from inspiration to expiration, the right ventricular systolic "plateau" very often presented an ascending slant, i.e., reaching maximum pressure in late instead of early systole, as usually observed in the other moments of the respiratory cycle.(ABSTRACT TRUNCATED AT 250 WORDS)

Pharmacological evaluation of 5-(Z,E)-13,14-didehydro-20-methyl-carboprostacyclin (FCE 22509).

FCE 22509, 5-(Z,E)-13,14-didehydro-20-methyl-carboprostacyclin, a chemically stable prostacyclin (PGI2) derivative, was 3.5 times more potent than PGI2 in relaxing bovine coronary artery in vitro; unlike PGI2, it did not contract bovine coronary vein and it antagonized PGI2-induced contractions of the coronary vein. In vitro smooth muscle (guinea pig ileum and trachea and rat stomach strip) was contracted to a lesser extent than with PGI2. FCE 22509 was about five times less potent than PGI2 in deaggregating platelet clumps formed on rabbit Achilles tendon bathed with heparinized cat blood (ED50 = 7.6 and 1.6 mcg/kg i.v. respectively). In the conscious normotensive and spontaneously hypertensive rat FCE 22509 lowered mean systemic arterial pressure (MSAP) (ED25 = 11.5 and 4.8 mcg/kg i.v.) to a lesser extent than PGI2 (ED25 = 2.1 and 2.34 mcg/kg i.v.) and increased heart rate but not dose-dependently. Orally administered, FCE 22509 likewise reduced MSAP though at high dosages (ED30 = 1.33 and 1.02 mg/kg in normotensive and hypertensive rats). Heart rate (HR) was raised after i.v. and oral treatment but not dose-dependently. In the open-chest anaesthetized dog, FCE 22509, compared with PGI2 at the same three doses, 0.2, 0.4 and 0.8 mcg/kg i.v., lowered MSAP but its hypotensive effect was less pronounced than that of PGI2. Like PGI2, FCE 22509 did not modify HR (though PGI2 showed a tendency to a decrease and FCE 22509 seemed to increase this cardiovascular function) and mean pulmonary arterial pressure (MPAP) and likewise significantly reduced myocardial contractile force. After infusion of PGI2 and FCE 22509 0.2 mcg/kg i.v. for 15 min in the open chest anaesthetized cat, the ex-vivo ADP-induced inhibition of platelet aggregation was the same for both compounds. Unlike PGI2, which reduced MSAP and MPAP, FCE 22509 had no significant lowering effect on MSAP and MPAP.

Hypotensive effect in the rat after oral prostacyclin (PGI2).

PGI2 dose dependently lowers mean systemic arterial pressure in conscious normotensive and spontaneously hypertensive rats after oral administration. The ED30 was respectively 0.79 and 0.63 mg/kg. Heart rate was not significantly modified. The hypotensive effect appears to be due to PGI2 itself and not to its metabolite 6-keto-PGF1 alpha which, administered at 2 mg/kg p.o., did not modify blood pressure.

dl-9a-Deoxy-9a-methylene-PGI2 (a stable prostacyclin derivative): preliminary pharmacological data.

Carboprostacyclin (dl-9a-deoxy-9a-methylene-PGI2), a new stable PGI2-analogue, has been studied in vitro and in vivo. This analogue relaxes bovine coronary artery (potency ratio to PGI2 = 0.17), inhibits human PRP aggregation induced by ADP (IC50 = 12.5 nM2), deaggregates platelet clumps in cat heparinized blood (ED50 = 10.4 microgram/kg) and raises cAMP content in human PRP, but is less potent than PGI2. It is less potent (about 30 times) than PGI2 in lowering blood pressure in anaesthetized rats, inhibits basal gastric secretion in the rat and is 8 and 6 times less potent than PGE2 in protecting rat gastric mucosa from the lesions induced by stress and ASA, respectively, and about half as potent as PGE2 in protecting intestinal mucosa from damage by indomethacin.