Potassium and isolated coronary vascular smooth muscle

Norton, JM; Detar, R

doi:10.1152/ajplegacy.1972.222.2.474

Cited by 34 publications

(29 citation statements)

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“…At high concentrations (>15 mmol/l) potassium causes smooth muscle contraction in isolated arterial preparations. 5 The exacerbation of chest pain experienced by our patient after each intracoronary injection may therefore have been caused by aggravation of myocardial ischaemia due to coronary vasospasm. Such problems can be avoided by using a preparation of glyceryl trinitrate that does not contain potassium.…”

Section: Discussionmentioning

confidence: 72%

“…Tridil is supplied in 10 ml ampoules containing 5 Webb, Canepa-Anson, Rickards, Poole-Wilson concentration is a factor in initiating ventricular arrhythmias,3 particularly in the context of myocardial ischaemia.4 Although our patient remained in sinus rhythm, arrhythmias represent a potential hazard of giving intracoronary injections containing high concentrations of potassium. A further risk arises from the vasoactive properties of potassium.…”

Section: Discussionmentioning

confidence: 94%

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High potassium concentration in a parenteral preparation of glyceryl trinitrate. Need for caution if given by intracoronary injection.

Webb¹,

Canepa‐Anson²,

Rickards³

et al. 1983

Heart

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SUMMARY Glyceryl trinitrate (Tridil) was given by intracoronary injection to a patient who developed coronary artery spasm during angioplasty. Transient exacerbation of chest pain and electrocardiographic changes occurred. This formulation of the drug contins a high concentration of potassium ions and should not be given by this route.Intracoronary injection of glyceryl trinitrate has been recommended for controlling acute coronary artery spasm occurring during routine cardiac catheterisation or percutaneous transluminal angioplasty.12 We report a case where this form of treatment, given for spasm of the left anterior descending coronary artery after percutaneous transluminal angioplasty, caused transient exacerbation of angina and electrocardiographic changes. These events were associated with an increase in the coronary sinus potassium concentration resulting from potassium contained in the vehicle for the drug. Case reportA 58 year old woman was investigated because of increasing angina resistant to conventional medical treatment. Treadmill exercise testing provoked typical chest pain without appreciable electrocardiographic changes, but Holter monitoring showed ST segment depression in lead CM5 during spontaneous pain and rapid atrial pacing. Coronary angiography showed a severe proximal stenosis of the left anterior descending coronary artery which was considered to be suitable for percutaneous transluminal angioplasty. At the start of the procedure a potassium sensitive electrode was positioned in the coronary sinus as part of a study on the effect of transient coronary artery occlusion. Angioplasty was performed using a Gruntzig balloon catheter (Schneider-Medintag GA-20-30) inflated to 5 bar for 20 s. The initial mean pressure gradient across the stenosis was 60 mmHg.After the third dilatation the patient developed chest pain accompanied by ST (Fig a), while injection of 250 ,g caused ST segment elevation and T wave peaking, which persisted for 2 minutes (Fig b). After each bolus of glyceryl trinitrate the coronary sinus potassium concentration rose transiently by between 0-9 and 2.6 mmol/l (mean 1-55 mmol/l, n=8). The increase in coronary sinus potassium concentration occurred about 4 s after each injection and persisted for between 12 and 30 s.Glyceryl trinitrate was then given intravenously by bolus injections (250,ug twice) followed by an infusion (40 yg/min). The patient's chest pain subsided, and the electrocardiogram returned to normal. Angiography confirmed that the left anterior descending coronary artery was patent with reduction of the severity of the stenosis. Recovery was uneventful, and the patient has no further angina. Treadmill exercise testing was negative and did not provoke chest pain. DiscussionThe transient rise in coronary sinus porassium concentration after each intracoronary injection of glyceryl trinitrate suggested that a bolus of fluid rich in potassium had passed through the coronary circulation. Tridil is supplied in 10 ml ampoules containing 5 mg of glyceryl trinitrate s...

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Section: Discussionmentioning

confidence: 72%

Section: Discussionmentioning

confidence: 94%

High potassium concentration in a parenteral preparation of glyceryl trinitrate. Need for caution if given by intracoronary injection.

Webb¹,

Canepa‐Anson²,

Rickards³

et al. 1983

Heart

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“…Vagally mediated vasodilation also occurs in coronary (Feigel, 1969;Norton & Detar, 1972) and in uterine vasculatures (Bell, 1972(Bell, , 1974.…”

Section: Discussionmentioning

confidence: 99%

Adrenergic transmissions in the guinea‐pig mesenteric artery and their cholinergic modulations.

Kuriyama¹,

Suzuki²

1981

The Journal of Physiology

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SUMMARY1. Neuromuscular transmission in the guinea-pig mesenteric artery and the effects of acetylcholine (ACh) on transmission were investigated by the micro-electrode method.2. The membrane potential, length and time constant of the smooth muscle of the mesenteric artery were found to be -69-6+ 1-9 mV, 0-81 +0-15 mm and 129 + 42 msec, respectively.3. Perivascular nerve stimulation produced an excitatory junction potential (e.j.p.) and repetitive stimulation produced facilitation. When the amplitude of an e.j.p. reached threshold, a spike was evoked.4. Very rarely, miniature e.j.p.s. were recorded. The amplitude histogram showed a skew distribution. Increases in the stimulus intensity enlarged the amplitude of e.j.p.s as a stepwise manner. These results indicate multiple innervation to the muscle cells.5. The time constant of the falling phase of an e.j.p. was consistently larger than that of the muscle membrane.6. ACh, in concentrations of less than 108 M, suppressed the e.j.p. amplitude without change in the membrane potential and resistance of the muscle membrane, but accelerated facilitation. These ACh actions were suppressed by pre-treatment with atropine.7. ACh suppressed neither the conduction velocity of excitation of adrenergic nerves nor the number of nerves contributing to the generation of an e.j.p.8. These results suggest that pre-and post-junctional muscarinic receptors possess different sensitivities to ACh, and a low concentration of ACh (< 10-8 M) solely suppressed the release of noradrenaline by activating the pre-junctional muscarinic receptors.

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“…Many investigators have shown that potassium at the increased concentrations observed in venous blood during exercise and hypoxia can relax smooth muscle both in vivo (5)(6)(7)(8)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) and in vitro (21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31). Therefore, this ion.…”

mentioning

confidence: 99%

“…Furthermore, no data are currently available showing the temporal response pattern of microvessels during variations in potassium concentration. These data are of particular interest in view of the transient potassium ion release during functional hyperemia in striated muscle (7,8) and the transient vascular smooth muscle response to potassium both in vitro (26)(27)(28)(29)(30)(31)(32) and in vivo (10).…”

mentioning

confidence: 99%

Effects of potassium ion on the microcirculation of the hamster.

Duling¹

1975

Circulation Research

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The vasoactive properties of potassium were assessed in the microcirculation of the hamster cremaster muscle and the muscular and epithelial portions of the hamster cheek pouch. Tissues were transilluminated and suffused with a physiological salt solution whose potassium concentration varied from 0 to 20 mM. Vessel diameters were measured and normalized as a percent of the control diameter (± SE) observed during exposure to 4.7 mM K + . Altering the potassium concentration in the suffusion solution caused a transient vascular response. The peak changes in the vascular diameter of the arterioles supplying striated muscle varied directly with the suffusion solution potassium concentration from a minimum of 78 ± 3% in 0 mM K + to 155 ± 15% in 15 mM K". Vascular diameter increases were sustained for the full 5-minute test period only in 15 mM K+. In the epithelial portions of the cheek pouch, only the constrictor component of the potassium response was observed. The data indicate that potassium is sufficiently potent to participate in initiating functional hyperemia in striated muscle and might cause as much as a 6.3-fold increase in flow. Functional hyperemias exceeding approximately 3 minutes cannot be due to potassium ion, since the dilation induced by this agent is transient.• Cells contain a large store of labile potassium that can be released by various stimuli such as muscle contraction and hypoxia (1-9). Many investigators have shown that potassium at the increased concentrations observed in venous blood during exercise and hypoxia can relax smooth muscle both in vivo (5)(6)(7)(8)(10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) and in vitro (21-31). Therefore, this ion. may be important in the local control of blood flow. However, further quantification of the reactivity of resistance vessels to the ion must be carried out before accurate estimates of the importance of potassium in blood flow regulation can be made. These data can be obtained by studying microvessel responses to alterations in suffusion solution potassium concentrations, but such experiments have only been performed on pial vessels (11,16,17). Furthermore, no data are currently available showing the temporal response pattern of microvessels during variations in potassium concentration. These data are of particular interest in view of the transient potassium ion release during functional hyperemia in striated muscle (7,8) and the transient vascular smooth muscle response to potassium both in vitro (26-32) and in vivo (10). A preliminary report of this work was presented at the Fall Meeting of the American Physiological Society, August, 1974. This work was done during Dr. Duling's tenure as an Established Investigator of the American Heart Association.Received September 20, 1974. Accepted for publication June 4, 1975. I have therefore studied the responses of the arterioles of the hamster cremaster muscle and cheek pouch to changes in the potassium concentration of a superfusion solution. The aims of the experiment were to: (1) estab...

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Potassium and isolated coronary vascular smooth muscle

Cited by 34 publications

References 0 publications

High potassium concentration in a parenteral preparation of glyceryl trinitrate. Need for caution if given by intracoronary injection.

High potassium concentration in a parenteral preparation of glyceryl trinitrate. Need for caution if given by intracoronary injection.

Adrenergic transmissions in the guinea‐pig mesenteric artery and their cholinergic modulations.

Effects of potassium ion on the microcirculation of the hamster.

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