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Chemoreflexes: an experimental study.

B B Chiang1, A M Roberts, A M Kashem

  • 1Department of Surgery, The Jewish Hospital Heart and Lung Institute, Louisville, KY 40202, USA. b0chia01@louisville.edu

Archives of Surgery (Chicago, Ill. : 1960)
|May 12, 2000
PubMed
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Transmyocardial laser revascularization (TMLR) does not denervate the heart. Cardiac afferent nerve stimulation and reflex responses remain intact after TMLR, indicating it

Area of Science:

  • Cardiology
  • Neurosurgery
  • Cardiac Physiology

Background:

  • Transmyocardial laser revascularization (TMLR) is a procedure used to treat refractory angina.
  • The mechanism by which TMLR improves angina is not fully understood, with denervation being a proposed factor.

Purpose of the Study:

  • To investigate whether Transmyocardial laser revascularization (TMLR) leads to cardiac denervation.
  • To determine if stimulation of cardiac sympathetic and vagal afferents after TMLR can evoke reflex effects.

Main Methods:

  • The study examined the effect of TMLR on reflexes evoked by chemical stimulation of cardiac afferents in 9 dogs.
  • Bradykinin and capsaicin were used to stimulate cardiac afferents before and after TMLR, vagotomy, and sympathectomy.
  • Hemodynamic parameters including aortic pressure and left ventricular pressure were monitored.

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Main Results:

  • Stimulation of cardiac afferents with bradykinin and capsaicin elicited pressor and depressor responses.
  • These hemodynamic responses remained intact after TMLR.
  • Responses were diminished after vagotomy and abolished after sympathectomy, confirming the role of intact neural pathways.

Conclusions:

  • Transmyocardial laser revascularization (TMLR) does not cause sufficient cardiac denervation to explain angina improvement.
  • The preservation of cardiac afferent nerve function and reflex responses after TMLR suggests alternative mechanisms for symptom relief.