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J Thorac Cardiovasc Surg 1997;113:770-776
© 1997 Mosby, Inc.

CARDIOPULMONARY BYPASS, MYOCARDIAL MANAGEMENT, AND SUPPORT TECHNIQUES

INFLUENCE OF BASAL RELEASE OF NITRIC OXIDE ON SYSTOLIC AND DIASTOLIC FUNCTION OF BOTH VENTRICLES

Supported by The National Heart and Lung Institute, London, United Kingdom.

Received for publication Feb. 12, 1996 revisions requested March 18, 1996; revisions received Nov. 6, 1996; accepted for publication Nov. 19, 1996. Address for reprints: Pankaj Mankad, FRCS (C/Th), Consultant Cardiac Surgeon, The Royal Hospital for Sick Children, Sciennes Rd., Edinburg EH9 1LF, Scotland, United Kingdom.

Abstract

Nitric oxide is continuously released by coronary artery endothelium under basal conditions; it maintains vascular tone and regulates coronary blood flow. The objective of this study was to investigate the influence of this basal release of nitric oxide on right and left ventricular systolic and diastolic function. Isolated pig hearts perfused at a constant pressure with enriched autologous blood were used. Systolic and diastolic pressure-volume relationships of isovolumically contracting hearts were studied in the control setting and after addition of 1 mmol/L L-N^G-monomethyl-arginine followed by 5 mmol/L L-arginine to the perfusate. Addition of L-N^G-monomethyl-arginine caused an acute rise in coronary vascular resistance and a reduction in right and left ventricular systolic function as evaluated by the slope values of the pressure-volume curves, but had little effect on the diastolic function of either ventricle. L-Arginine restored the systolic function to the control level. This alteration in ventricular function was not a result of ischemia because myocardial oxygen consumption was not significantly affected by the acute increase in coronary vascular resistance induced by L-N^G-monomethyl-arginine. We conclude that basal release of nitric oxide has no direct negative inotropic effect, but in fact plays an important role in preserving right and left ventricular systolic function and maintains the basal coronary vascular tone.

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