Document Detail


Maximal coronary vasodilator capacity of orthotopic heart transplants in patients with and without rejection.
MedLine Citation:
PMID:  2672759     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In cardiac allograft rejection, histopathologic changes suggesting that myocardial ischemia is a component of the rejection process have been documented. To further define the coronary vascular reactivity of human heart transplant, coronary sinus blood flow and coronary resistance were measured before and after intravenous dipyridamole within the first year after transplantation in 8 patients without rejection (group II) and in 5 patients with rejection (group III). All had normal coronary arteriograms. Results were compared to those of 8 control subjects (group I). After dipyridamole, coronary sinus blood flow was increased in groups I, II and III by 303, 212 (p less than 0.01 vs group I) and 45%, respectively (p less than 0.001 vs groups I and II). Coronary resistance was reduced by 77, 73 (not significant vs group I) and 36%, respectively (p less than 0.001 vs groups I and II). Concomitantly, coronary sinus blood oxygen content was increased by 172, 145 (not significant vs group I) and 78%, respectively (p less than 0.001 vs group I, not significant vs group II). Thus, the coronary flow reserve evaluated by the dipyridamole/basal coronary sinus blood flow ratio and the coronary resistance reserve evaluated by the basal/dipyridamole coronary resistance ratio were dramatically impaired in group III (1.56 +/- 0.09 and 1.63 +/- 0.30, respectively, p less than 0.001 vs groups I and II). In contrast, they were almost normal in group II (3.11 +/- 0.42 vs 4.03 +/- 0.52 in group I, p less than 0.02, and 3.83 +/- 0.78 vs 4.45 +/- 0.81 in group I, difference not significant). Thus, the impairment of coronary reserve during heart rejection should be linked to abnormalities of the coronary microvaculature. This emphasizes the important involvement of the coronary circulation in the rejection process.
Authors:
A Nitenberg; O Tavolaro; D Loisance; J M Foult; L Hittinger; E Aptecar; J P Cachera
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The American journal of cardiology     Volume:  64     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1989 Sep 
Date Detail:
Created Date:  1989-10-05     Completed Date:  1989-10-05     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  513-8     Citation Subset:  AIM; IM    
Affiliation:
Service de Physiologie et d'Explorations Fonctionnelles, Institut National de la Santé et de la Recherche Médicale Unité 251, Centre Hospitalier Universitaire Xavier-Bichat, Paris, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angiography
Coronary Angiography
Coronary Vessels / physiopathology*
Dipyridamole / diagnostic use
Female
Graft Rejection*
Heart Transplantation*
Hemodynamics
Humans
Male
Middle Aged
Myocardium / metabolism
Reference Values
Vasodilation*
Chemical
Reg. No./Substance:
58-32-2/Dipyridamole

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


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