Effect of basal epicardial tone on endothelium-independent coronary flow reserve measurement

✍ Scribed by Hasdai, David ;Holmes, David R. ;Higano, Stuart T. ;Lerman, Amir

• Publisher: John Wiley and Sons
• Year: 1998
• Tongue: English
• Weight: 73 KB
• Volume: 44
• Category: Article
• ISSN: 0098-6569
• DOI: 10.1002/(sici)1097-0304(199808)44:4<392::aid-ccd5>3.0.co;2-#

✦ Synopsis

Increased basal epicardial tone may attenuate the coronary flow reserve (CFR) by causing vasodilatation of resistance vessels. We examined the effect of basal epicardial tone on the endothelium-independent CFR measurements in subjects with nonobstructive coronary disease. Patients underwent evaluation of endothelium-independent CFR using adenosine (18-36 µg) and endothelium-dependent CFR using acetylcholine (10 ؊6 M-10 ؊4 M), both administered intracoronary. CFR to adenosine, presented as the ratio of Doppler flow velocities post-and pre-adenosine, was measured at baseline and after intracoronary nitroglycerin (200 µg). Nitroglycerin increased the coronary artery diameter by 19.7 ؎ 2.5%, and decreased the coronary vascular resistance from 3.0 ؎ 0.2 mm Hg/ml/min to 1.8 ؎ 0.1 mm Hg/ml/min (p F 0.0001). The response to adenosine at baseline and after nitroglycerin was similar (CFR ratio of 2.52 ؎ 0.09 and 2.57 ؎ 0.10, respectively, p ‫؍‬ NS). The effect of nitroglycerin on the response to adenosine did not correlate with coronary endothelial function (r 2 ‫؍‬ 0.06, p ‫؍‬ 0.13). The basal epicardial tone does not affect CFR measurements in patients with angina and nonobstructive coronary disease. Cathet.