| English |
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| Title | Myocardial ischemia and sympathetic activity |
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| Subtitle | (special edition) International Symposium on Ischemic Heart and Anesthesia |
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| Authors | Arifumi Kohyama |
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| Authors(kana) | |
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| Organization | Department of Anesthesiology,Tokushima University School of Medicine |
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| Journal | Circulation Control |
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| Volume | 13 |
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| Number | 3 |
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| Page | 385-388 |
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| Year/Month | 1992/ |
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| Article | Report |
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| Publisher | Japan Society of Circulation Control |
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| Abstract | 「Introduction」It has been emphasized that the balance of myocardial oxygen demand and supply should be maintained for the prevention of myocardial ischemia during anesthesia in the patients with coronary artery disease. Recently, using transesophageal echocardiography or longterm ECG monitoring in the perioperative period, new myocardial ischemia was shown to occur in 20-40% of patients undergoing coronary artery bypass graft surgery1,2). Since myocardial ischemia is accompanied by no remarkable hemodynamic changes, the decreased coronary blood flow in the ischemic myocardium rather than the increased myocardial oxygen consumption appears to be responsible for the development of new myocardial ischemia. Stimulation of sympathetic nerves was reported to contract the coronary artery. Alpha adrenoreceptors may be subdivided into types 1 and 2. Coronary vascular smooth muscle has postjunctional alpha 1 and alpha 2 receptors, both of which induce vasoconstriction. Adrenergic vasoconstriction of epicardial large coronary artery is predominantly mediated via alpha 1 receptors in contrast to resistant small arteries where both alpha 1 and alpha 2 receptors are involved. |
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| Practice | Basic medicine |
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