| Persistence of coronary vasodilator responsivity after cardiac transplantation. | |
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MedLine Citation:
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PMID: 8427178 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Accelerated graft atherosclerosis is a major cause of death after cardiac transplantation. Although its detection currently requires surveillance angiography, loss of vasodilator responsivity may precede obstructive lesions and be detectable by noninvasive assessment of myocardial perfusion. Thirty-five allograft recipients were studied an average of 31 +/- 19 (mean +/- SD) months after transplantation. All were free from angiographically definable macrovascular obstructive coronary artery lesions. Nutritive myocardial perfusion at rest, estimated in absolute terms by positron emission tomography with oxygen-15 water averaged 1.63 +/- 0.51 ml/g/min in patients and was greater than that in 26 healthy volunteers (1.17 +/- 0.33 ml/g/min, p < 0.001). The increase correlated with increased cardiac work at rest in transplant recipients with arterial hypertension and tachycardia. Peak myocardial perfusion induced by intravenous administration of dipyridamole was normal in the transplant recipients (3.49 +/- 1.70 ml/g/min compared with 3.60 +/- 1.41 ml/g/min in volunteers). Because of the high flow at rest, myocardial perfusion reserve (the ratio of hyperemic flow to flow at rest) was diminished (2.3 +/- 1.2 compared with 3.3 +/- 1.5 in volunteers, p < 0.005). These results indicate that the responsivity to vasodilator stimulation is well preserved in transplant recipients devoid of macroscopic coronary arterial lesions obviating detection of early vascular dysfunction in individual subjects. Positron emission tomography may be useful, however, in quantifying the magnitude of the increase in flow at rest secondary to increased cardiac work--a potentially remedial cause of accelerated coronary vascular disease induced by high shear force activation of platelets in the coronary bed, and in detecting impaired perfusion once macrovascular vascular disease is extant. |
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Authors:
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M J Senneff; J Hartman; B E Sobel; E M Geltman; S R Bergmann |
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Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: The American journal of cardiology Volume: 71 ISSN: 0002-9149 ISO Abbreviation: Am. J. Cardiol. Publication Date: 1993 Feb |
Date Detail:
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Created Date: 1993-03-04 Completed Date: 1993-03-04 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0207277 Medline TA: Am J Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 333-8 Citation Subset: AIM; IM |
Affiliation:
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Cardiovascular Division, Washington University School of Medicine, St. Louis, Missouri 63110. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Carbon Radioisotopes / diagnostic use Coronary Circulation / drug effects Coronary Disease / physiopathology, radionuclide imaging, surgery Coronary Vessels / physiopathology*, radionuclide imaging Dipyridamole / diagnostic use Female Heart Transplantation / physiology* Hemodynamics / drug effects Humans Male Middle Aged Oxygen Radioisotopes / diagnostic use Postoperative Period Tomography, Emission-Computed / instrumentation, methods Transplantation, Homologous Vasodilation* / drug effects |
| Grant Support | |
ID/Acronym/Agency:
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HL17646/HL/NHLBI NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Carbon Radioisotopes; 0/Oxygen Radioisotopes; 58-32-2/Dipyridamole |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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