Document Detail

Flow-mediated vasodilation during pacing of the free epigastric artery bypass graft early and late postoperatively.
MedLine Citation:
PMID:  8557914     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The free epigastric artery bypass graft is proposed as an alternative conduit to the saphenous vein graft, known for its high rate of attrition. The aim of our study was to assess its endothelial function in vivo. BACKGROUND: The endothelium of arterial bypass grafts plays a role in both the performance and the patency of such grafts. METHODS: We studied 73 epigastric grafts early (mean +/- SD 10 +/- 3 days) and 36 late (12 +/- 5 months) after coronary bypass surgery with quantitative angiography at rest, after 2 min of atrial pacing (130 beats/min) and after injection of isosorbide dinitrate (1 to 2 mg) into the graft. RESULTS: At rest, mean epigastric graft diameter was lower in the late than in the early postoperative period (2.26 +/- 0.39 vs. 2.61 +/- 0.49 mm, p < 0.001). Early after operation, epigastric grafts with a small or an intermediate runoff, but not those with a large runoff, were capable of vasodilation with nitrates (+0.09 +/- 0.10 mm). Late after operation, vasodilation after administration of isosorbide dinitrate was similar in epigastric grafts with a large runoff and in those with a small or intermediate runoff (+ 0.23 +/- 0.09 vs. +0.23 +/- 0.18 mm). Significant vasodilation during pacing was observed late (+4 +/- 9%, p < 0.01) but not early postoperatively, except in a subset of patients with grafts capable of vasodilation after nitrates. A correlation between the response to nitrates and the response during pacing was observed early (r = 0.579, p < 0.001) and late postoperatively (r = 0.530, p = 0.02). CONCLUSIONS: Flow-mediated vasodilation during pacing was observed in most epigastric grafts late, but not early, after operation. This endothelium-dependent dilation was correlated with the importance of the vasodilation observed with nitrates (endothelium-independent), which was related to the importance of the runoff only in the early postoperative period. The ability of epigastric grafts late postoperatively to dynamically adapt their dimensions to an acute increase in demand could contribute to the good functional results of this new alternative arterial graft.
O Gurn?; P Chenu; M Buche; J Jamart; Y Louagie; P Eucher; B Marchandise; E Schroeder
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  27     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1996 Feb 
Date Detail:
Created Date:  1996-02-26     Completed Date:  1996-02-26     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  415-20     Citation Subset:  AIM; IM    
Department of Cardiology, University of Louvain, Mont-Godinne Hospital, Yvoir, Belgium.
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MeSH Terms
Cardiac Pacing, Artificial
Coronary Angiography
Coronary Artery Bypass / methods*
Coronary Circulation / physiology*
Endothelium, Vascular / physiology*
Epigastric Arteries / physiology*,  transplantation*
Heart Catheterization
Image Processing, Computer-Assisted
Isosorbide Dinitrate / diagnostic use
Middle Aged
Postoperative Period
Time Factors
Vascular Patency / physiology
Vasodilation / physiology*
Vasodilator Agents / diagnostic use
Reg. No./Substance:
0/Vasodilator Agents; 87-33-2/Isosorbide Dinitrate

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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