Silva MT, Palheta RC Jr, Oliveira FG, de Lima JB, AntunesRodrigues J, Oliveira RB, Magalhães PJ, Santos AA. Aortocaval fistula delays gastric emptying of liquid test meal in awake rats. Am J Physiol Heart Circ Physiol 304: H1397-H1405, 2013. First published March 15, 2013 doi:10.1152/ajpheart.00827.2012.-Arteriovenous anastomoses disrupt cardiovascular and renal homeostasis, eliciting hemodynamic adjustments, resetting the humoral pattern, and inducing cardiac hypertrophy. Because acute circulatory imbalance alters gut motor behavior, we studied the effects of arteriovenous fistula placement on the gastric emptying (GE) of a liquid meal in awake rats. After laparotomy, we created an aortocaval fistula (ACF) by aorta and cava wall puncture with a 21-, 23-, or 26-gauge needle. The ACF was not created in the control group, which underwent sham operation. After 12, 24, or 48 h, mean arterial pressure, heart rate, and central venous pressure were continuously recorded, and cardiac output was estimated by thermal dilution. The rats were then gavage fed a test meal (i.e., phenol red in glucose solution), and fractional dye retention was determined 10, 20, or 30 min later. The effect of prior bleeding on ACF-induced GE delay, the role of neuroautonomic pathways, and changes in plasma hormone levels (i.e., angiotensin II, arginine vasopressin, atrial natriuretic peptide, corticosterone, and oxytocin) were evaluated. When compared with the sham-operated group, ACF rats exhibited arterial hypotension, higher (P Ͻ 0.05) heart rate, central venous pressure, and cardiac output values and increased (P Ͻ 0.05) gastric dye retention, a phenomenon prevented by bilateral subdiaphragmatic vagotomy and hexamethonium treatment. Pirenzepine also impaired the occurrence of gastric delay in subjects with ACF. In addition to causing hyperkinetic circulation, ACF placement delayed the GE of liquid in awake rats, an effect that likely involves a parasympathetic pathway. arteriovenous fistula; gastrointestinal motility; hyperkinetic circulation; intestinal transit; natriuretic hormone HYPERKINETIC CIRCULATION IS a systemic condition that may originate from an arteriovenous (AV) fistula, either as a congenital malformation or acquired after invasive procedures (e.g., percutaneous renal biopsy), surgeries (e.g., nephrectomy), or trauma (e.g., stab or gunshot wounds) (11,24). Large AV fistulas are considered a simple and reliable model to elicit congestive heart failure (13). Laboratory animals with an aortocaval fistula (ACF) present hemodynamic and neurohumoral changes that resemble those seen in patients with heart failure, including cardiac hypertrophy (22). These animals have high levels of cardiac output (CO) and mean circulatory filling pressure, in addition to tachycardia, low resistance to blood flow in circulatory vessels, and decreased mean arterial pressure (MAP) (17).As a consequence of inducing such changes, the placement of an AV fistula activates complex neurohumoral mechanisms that may restore hemodynamic homeostasis. During ...