Coronary microcirculatory vasoconstriction is heterogeneously distributed in acutely ischemic myocardium

American Journal of Physiology. Heart and Circulatory Physiology
G SambucetiA L'Abbate

Abstract

The classical model of coronary physiology implies the presence of maximal microcirculatory vasodilation during myocardial ischemia. However, Doppler monitoring of coronary blood flow (CBF) documented severe microcirculatory vasoconstriction during pacing-induced ischemia in patients with coronary artery disease. This study investigates the mechanisms that underlie this paradoxical behavior in nine patients with stable angina and single-vessel coronary disease who were candidates for stenting. While transstenotic pressures were continuously monitored, input CBF (in ml/min) to the poststenotic myocardium was measured by Doppler catheter and angiographic cross-sectional area. Simultaneously, specific myocardial blood flow (MBF, in ml.min(-1).g(-1)) was measured by 133Xe washout. Perfused tissue mass was calculated as CBF/MBF. Measurements were obtained at baseline, during pacing-induced ischemia, and after stenting. CBF and distal coronary pressure values were also measured during pacing with intracoronary adenosine administration. During pacing, CBF decreased to 64 +/- 24% of baseline and increased to 265 +/- 100% of ischemic flow after adenosine administration. In contrast, pacing increased MBF to 184 +/- 66% of baseline, measu...Continue Reading

References

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Citations

Nov 16, 2012·European Journal of Nuclear Medicine and Molecular Imaging·Selene CapitanioCecilia Marini
May 27, 2009·Basic Research in Cardiology·Paul KnaapenAlbert C van Rossum
Feb 23, 2007·The New England Journal of Medicine·P G Camici, Filippo Crea
Jan 29, 2010·Journal of Cellular Biochemistry·Claudia KusmicNader G Abraham
May 26, 2012·Journal of the American College of Cardiology·Jayanth R ArnoldJoseph B Selvanayagam
May 7, 2016·Journal of Nuclear Cardiology : Official Publication of the American Society of Nuclear Cardiology·Cecilia MariniG Sambuceti
Feb 10, 2017·European Journal of Nuclear Medicine and Molecular Imaging·G SambucetiCecilia Marini
Dec 19, 2018·Microcirculation : the Official Journal of the Microcirculatory Society, Inc·Rajiv RampatJames Cockburn
Oct 31, 2018·Acta Anaesthesiologica Scandinavica·Adrian GononBirgitta Janerot-Sjoberg
May 2, 2006·American Journal of Physiology. Heart and Circulatory Physiology·Claudia KusmicG Sambuceti
Oct 4, 2006·Physiological Reviews·Nico WesterhofPieter Sipkema
Nov 22, 2015·American Journal of Physiology. Heart and Circulatory Physiology·Youngran Chung
Oct 2, 2007·American Journal of Physiology. Heart and Circulatory Physiology·A L'AbbateNader G Abraham
Jan 1, 2010·American Journal of Cardiovascular Drugs : Drugs, Devices, and Other Interventions·M MarzilliDoralisa Morrone

Related Concepts

Acute Disease
Angina Pectoris
Collateral Circulation
Coronary Artery Disease
Coronary Circulation
Electrocardiographic Recorders
Energy Metabolism
Microcirculation
Artificial Cardiac Pacemaker
Pulmonary Vascular Resistance

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