Effects of cardiac denervation on coronary and systemic circulation.

Abstract

The effects of cardiac denervation on coronary circulation and systemic hemodynamics were examined in patients who underwent coronary artery bypass grafting for a totally occluded left anterior descending coronary artery. The results in 14 patients who had undergone a combination of bypass grafting and intrapericardial denervation (group I) were compared with those in 19 patients who had undergone only bypass grafting (group II). The heart rate was 110 +/- 4.9 beats/min in group I and 104 +/- 3.7 beats/min in group II after denervation. Although the cardiac index was not significantly different between the two groups, the calculated systemic vascular resistance index of group I (1,358 +/- 111 dynes.s.cm-5.m2) was significantly lower (p < 0.02) than that in group II (1,713 +/- 75 dynes.s.cm-5.m2). The end-diastolic coronary resistance was significantly lower (p < 0.05) in group I (0.59 +/- 0.05 mm Hg.mL-1.min-1) than that in group II (1.04 +/- 0.14 mm Hg.mL-1.min-1), and the end-diastolic graft flow/mean graft flow ratio was 1.56 +/- 0.05 in group I and 1.28 +/- 0.04 in group II (p < 0.01). The plasma norepinephrine concentration in group I (223 +/- 52 pg/mL) was significantly low (p < 0.05) compared with that in group II (328 +/- 39 pg/mL) after denervation. Thus, cardiac denervation may have a beneficial effect on systemic hemodynamics and coronary circulation.