Nitric oxide-endothelin-1 interactions after surgically induced acute increases in pulmonary blood flow in intact lambs

Peter Oishi, Anthony Azakie, Cynthia Harmon, Robert K. Fitzgerald, Albert Grobe, Jie Xu, Karen Hendricks-Munoz, Stephen Matthew Black, Jeffrey R. Fineman

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Several congenital heart defects require surgery that acutely increases pulmonary blood flow (PBF). This can lead to dynamic alterations in postoperative pulmonary vascular resistance (PVR) and can contribute to morbidity and mortality. Thus the objective of this study was to determine the role of nitric oxide (NO), endothelin (ET)-1, and their interactions in the alterations of PVR after surgically induced increases in PBF. Twenty lambs underwent placement of an aortopulmonary vascular graft. Lambs were instrumented to measure vascular pressures and PBF and studied for 4 h. Before and after shunt opening, lambs received an infusion of saline (n = 9), tezosentan, an ETA- and ETB-receptor antagonist (n = 6), or N ω-nitro-L-arginine (L-NNA), a NO synthase (NOS) inhibitor (n = 5). In control lambs, shunt opening increased PBF by 117.8% and decreased PVR by 40.7% (P < 0.05) by 15 min, without further changes thereafter. Plasma ET-1 levels increased 17.6% (P < 0.05), and total NOS activity decreased 61.1% (P < 0.05) at 4 h. ET-receptor blockade (tezosentan) prevented the plateau of PBF and PVR, such that PBF was increased and PVR was decreased compared with controls at 3 and 4 h (P < 0.05). These changes were associated with an increase in total NOS activity (±61.4%; P < 0.05) at 4 h. NOS inhibition (L-NNA) after shunt placement prevented the sustained decrease in PVR seen in control lambs. In these lambs, PVR decreased by 15 min (P < 0.05) but returned to baseline by 2 h. Together, these data suggest that surgically induced increases in PBF are limited by vasoconstriction, at least in part by an ET-receptor-mediated decrease in lung NOS activity. Thus NO appears to be important in maintaining a reduction in PVR after acutely increased PBF.

Original languageEnglish (US)
JournalAmerican Journal of Physiology - Heart and Circulatory Physiology
Volume290
Issue number5
DOIs
StatePublished - May 1 2006

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Endothelin-1
Vascular Resistance
Nitric Oxide
Lung
Nitric Oxide Synthase
Endothelin Receptors
Blood Vessels
Congenital Heart Defects
Vasoconstriction
Arginine
Blood Pressure
Morbidity
Transplants
Mortality

Keywords

  • Congenital heart disease
  • Pulmonary circulation

ASJC Scopus subject areas

  • Physiology

Cite this

Nitric oxide-endothelin-1 interactions after surgically induced acute increases in pulmonary blood flow in intact lambs. / Oishi, Peter; Azakie, Anthony; Harmon, Cynthia; Fitzgerald, Robert K.; Grobe, Albert; Xu, Jie; Hendricks-Munoz, Karen; Black, Stephen Matthew; Fineman, Jeffrey R.

In: American Journal of Physiology - Heart and Circulatory Physiology, Vol. 290, No. 5, 01.05.2006.

Research output: Contribution to journalArticle

Oishi, Peter ; Azakie, Anthony ; Harmon, Cynthia ; Fitzgerald, Robert K. ; Grobe, Albert ; Xu, Jie ; Hendricks-Munoz, Karen ; Black, Stephen Matthew ; Fineman, Jeffrey R. / Nitric oxide-endothelin-1 interactions after surgically induced acute increases in pulmonary blood flow in intact lambs. In: American Journal of Physiology - Heart and Circulatory Physiology. 2006 ; Vol. 290, No. 5.
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AU - Grobe, Albert

AU - Xu, Jie

AU - Hendricks-Munoz, Karen

AU - Black, Stephen Matthew

AU - Fineman, Jeffrey R.

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AB - Several congenital heart defects require surgery that acutely increases pulmonary blood flow (PBF). This can lead to dynamic alterations in postoperative pulmonary vascular resistance (PVR) and can contribute to morbidity and mortality. Thus the objective of this study was to determine the role of nitric oxide (NO), endothelin (ET)-1, and their interactions in the alterations of PVR after surgically induced increases in PBF. Twenty lambs underwent placement of an aortopulmonary vascular graft. Lambs were instrumented to measure vascular pressures and PBF and studied for 4 h. Before and after shunt opening, lambs received an infusion of saline (n = 9), tezosentan, an ETA- and ETB-receptor antagonist (n = 6), or N ω-nitro-L-arginine (L-NNA), a NO synthase (NOS) inhibitor (n = 5). In control lambs, shunt opening increased PBF by 117.8% and decreased PVR by 40.7% (P < 0.05) by 15 min, without further changes thereafter. Plasma ET-1 levels increased 17.6% (P < 0.05), and total NOS activity decreased 61.1% (P < 0.05) at 4 h. ET-receptor blockade (tezosentan) prevented the plateau of PBF and PVR, such that PBF was increased and PVR was decreased compared with controls at 3 and 4 h (P < 0.05). These changes were associated with an increase in total NOS activity (±61.4%; P < 0.05) at 4 h. NOS inhibition (L-NNA) after shunt placement prevented the sustained decrease in PVR seen in control lambs. In these lambs, PVR decreased by 15 min (P < 0.05) but returned to baseline by 2 h. Together, these data suggest that surgically induced increases in PBF are limited by vasoconstriction, at least in part by an ET-receptor-mediated decrease in lung NOS activity. Thus NO appears to be important in maintaining a reduction in PVR after acutely increased PBF.

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