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Serotonin and acute cardiovascular disorders

  • Serotonin and Vascular Disease
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Summary

In this survey the possible role of serotonin in such acute disorders as systemic and pulmonary hypertension following cardiac surgery is discussed. Although platelets are activated during cardiopulmonary bypass, the increase in serotonin plasma levels is limited because the serotonin released is taken up by normal platelets and endothelial cells. This does not imply that serotonin is not involved in the origin of systemic hypertension during and after cardiac surgery, because subthreshold or threshold doses of this amine amplify the vasoconstrictive effect of, for example, epinephrine and norepinephrine, the levels of which are significantly elevated under these circumstances. That serotonin plays a role through its amplifying effect is supported by the finding that ketanserin, a specific S2-serotonergic receptor antagonist with α1- adrenergic receptor blocking properties, effectively lowers arterial blood pressure in patients with systemic postoperative hypertension by combined blockade of these receptors. The compound is also effective in the treatment of pulmonary hypertension after valve replacement, indicating that serotonin plays a role in the origin of this disorder. This idea is supported by the experimental finding that serotonin induces pulmonary hypertension. It is an interesting observation that, unlike such compounds as nitroprusside, ketanserin does not affect intrapulmonary shunting in patients with systemic hypertension and even reduces the intrapulmonary shunt fraction in patients with pulmonary hypertension. These findings indicate that this compound dilates the resistance vessels in well-ventilated, but not in poorly ventilated areas, and may dilate constricted bronchi. The latter assumption is supported by the finding that serotonin indeed induces bronchoconstriction in animals.

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Authors and Affiliations

  1. Department of Physiology, University of Limburg, MD Maastricht, The Netherlands

    Robert S. Reneman & Pieter J. A. van der Starre

  2. Department of Cardiothoracic Anesthesia, Hospital De Weezenlanden, Zwolle, The Netherlands

    Robert S. Reneman & Pieter J. A. van der Starre

Authors
  1. Robert S. Reneman
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  2. Pieter J. A. van der Starre
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Additional information

The authors are indebted to Jos Heemskerk, Emmy van Roosmalen, and Karin van Brussel for typing the manuscript and to Theo van der Nagel for making the illustrations.

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Reneman, R.S., van der Starre, P.J.A. Serotonin and acute cardiovascular disorders. Cardiovasc Drug Ther 4, 19–25 (1990). https://doi.org/10.1007/BF00053422

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