Key result
Targeting serotonin receptors may mitigate vascular dysfunction across cardiometabolic disease and cardiopulmonary bypass.
Why the study?
Serotonin is an important regulator of vascular tone whose aberrant activity contributes to vascular pathology in cardiometabolic disease and postoperative vascular dysfunction after cardioplegic arrest with cardiopulmonary bypass.
Targeting peripheral serotonin signaling, particularly through 5-HT2A and 5-HT1B receptors, offers a potential therapeutic avenue for mitigating vascular dysfunction in cardiometabolic diseases and cardiac surgery.
May support 5-HT receptor targeting to mitigate vascular dysfunction in cardiometabolic disease and post-CPB; hypothesis-generating, requiring prospective validation before practice change.
Serotonin (5-hydroxytryptamine, 5-HT) is a vasoactive amine and important regulator of vascular tone. Aberrant serotonergic activity contributes to vascular pathology in multiple cardiovascular disease states, including hypertension, diabetes, metabolic syndrome and chronic myocardial ischemia. Serotonin also plays a vital role in postoperative vascular dysfunction after cardioplegic arrest with cardiopulmonary bypass (CP/CPB). Perioperative microvascular dysfunction following CP/CPB manifests as an increased propensity for vasospasm or vasoplegia, with different effects in different tissue beds (coronary, skeletal muscle, pulmonary and systemic microcirculations). Given the importance of serotonin as a modulator of vasogenic responses, we present a selected narrative survey of the current literature concerning the effects of altered serotonergic activity on vascular dysfunction in the context of CP/CPB and other cardiometabolic diseases. This review begins with a discussion of normal serotonin biology and signaling pathways, then moves into disease-specific discussions covering five major areas of focus: metabolic syndrome, diabetes, hypertension, myocardial ischemia and CP/CPB.
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Joseph et al. (2026) conducted a review in Cardiometabolic disease and cardiac surgery. Serotonin signaling was evaluated. Aberrant serotonergic activity contributes to vascular pathology in cardiometabolic diseases and postoperative vascular dysfunction after cardiopulmonary bypass, highlighting serotonin receptors as potential therapeutic targets.
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