J Anesth
Department of Anesthesiology, Showa University Fujigaoka Hospital, 1-30 Fujigaoka, Aoba-ku, 227, Yokohama, Japan.
Published: March 1997
ATP and diadenosine tetraphosphate (APA) have been shown to produce vasodilation mediated by P- and P-purinoceptor, respectively. The differing mechanisms involved in this vasodilating activity may induce different systemic hemodynamic changes. We compared the hemodynamic effects of APA-induced hypotension with those induced by ATP. Fourteen mongrel dogs were anesthetized with 0.87% halothane in oxygen (1 MAC). After the baseline period, mean arterial pressure was reduced to 60 mmHg for 60 min by the infusion of APA or ATP. The ATP- and APA-induced hypotension resulted in a maximum reduction in systemic vascular resistance of 43% and 46%, respectively (P<0.01), associated with a significant increase in stroke volume index. With ATP, a 20% of maximum increase (P<0.05) in cardiac index (CI) was observed during the induced hypotension. In contrast, APA-induced hypotension did not result in any changes in CI throughout the observation period. The varying results concerning CI during the ATP- and APA-induced hypotension were probably due to differences in ventricular filling pressure, since APA-induced hypotension was associated with decreases (P<0.01) in both right atrial and pulmonary capillary wedge pressures, whereas neither of these variables significantly changed with ATP. The hypotension induced by either ATP or APA was associated with a significant decrease in heart rate (HR). However, both the magnitude and duration of decreases in HR due to ATP-induced hypotension were more pronounced than those seen with APA. In conclusion, while both drugs were equally capable of inducing hypotension, our results suggest that APA was more suitable for induced hypotension because of its potent vasodilatory action with venodilation and less negative chronotropic action.
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