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Cardiac norepinephrine stores and chronotropic reflex response after thoracotomy

H R Schelbert, R S Pavelec, S Sandoval

    Journal of Applied Physiology
    |August 1, 1975
    PubMed
    Summary

    Thoracic surgery significantly reduces cardiac norepinephrine stores and impairs the heart rate reflex response to hypotension in dogs. This study links reduced norepinephrine levels to a diminished chronotropic response following surgery.

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    Area of Science:

    • Cardiovascular Physiology
    • Surgical Research

    Background:

    • Thoracic operations are known to alter cardiac reflex activity and norepinephrine levels.
    • The direct physiological link between these post-operative changes remains under-investigated.

    Purpose of the Study:

    • To investigate the relationship between alterations in cardiac norepinephrine stores and cardiac reflex activity following thoracic surgery.
    • To quantify changes in norepinephrine levels and heart rate response to hypotension post-thoracotomy.

    Main Methods:

    • Assessed cardiac norepinephrine stores in dogs before and after right thoracotomy.
    • Measured the heart rate response to induced arterial hypotension in dogs pre- and post-surgery.
    • Correlated changes in norepinephrine levels with the attenuation of the chronotropic response.

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    Main Results:

    • A significant 33% depression in right atrial norepinephrine stores was observed within one week post-surgery (P < 0.05).
    • The heart rate response to a 17-20 mmHg drop in systolic blood pressure was markedly reduced by 67.8% (P < 0.05).
    • Decreased norepinephrine stores were paralleled by an attenuated chronotropic response to hypotension.

    Conclusions:

    • Post-thoracotomy, reduced cardiac norepinephrine stores correlate with impaired baroreflex sensitivity.
    • These findings highlight a physiological consequence of thoracic surgery on cardiac autonomic regulation.