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Articles in PresS, published online ahead of print February 1, 2002
J Appl Physiol, 10.1152/jap.01025.2001
Submitted on October 11, 2001
Accepted on January 20, 2002
1 Department of Anesthesiology, Mayo Clinic, Rochester, MN, USA
2 Department of Neurosurgery, Mayo Clinic, Rochester, MN, USA
3 Department of Neurology, Mayo Clinic, Rochester, MN, USA
* To whom correspondence should be addressed. E-mail: joyner.michael{at}mayo.edu, lechtenberg.bettie@mayo.edu.
To determine if endothelial function is altered by chronic surgical sympathectomy, we infused ACh, isoproterenol, nitroprusside (NTP), and the nitric oxide synthase (eNOS) inhibitor NG-mono-methyl-L-arginine (L-NMMA), into the brachial arteries of nine patients 5-64 months after thoracic sympathectomy for hyperhidrosis. Age- and gender-matched controls were also studied. Forearm blood flow (FBF) was measured by venous occlusion plethysmography. Lower body negative pressure (LBNP) was used to assess reflex vasoconstrictor responses. Tyramine, which acts locally and causes norepinephrine release from sympathetic nerves was also administered via the brachial artery. FBF at rest was 2.5 ± 0.4 ml.dl-1.min-1 in the patients and 2.5 ± 0.3 ml.dl-1.min-1 in the controls (P = 0.95). The normal vasoconstrictor responses to LBNP were abolished in the patients. By contrast, tyramine produced dose-dependent vasoconstriction in the patients that was identical to controls. The dose response curves to ACh were similar in patients and controls with maximum values of 19.3 ± 4.4 versus 25.5 ± 2.8 ml.dl-1.min-1 respectively. L-NMMA reduced baseline forearm blood flow similarly and reduced the maximal FBF response to ACh in both groups (patients, 8.9 ± 3.5 versus controls 9.7 ± 2.5 ml.dl-1.min-1). The vasodilation to isoproterenol was similar and blunted to the same extent in both groups by L-NMMA. The responses to NTP in patients and controls were similar and not affected by L-NMMA. We conclude that in humans, chronic surgical sympathectomy does not cause major disruptions in vascular function in the forearm. The normal vasoconstrictor responses to tyramine indicate that there were viable sympathetic nerves in the forearm that were not engaged by LBNP.
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