Document Detail

Reduced coronary flow reserve during exercise in cardiac transplant recipients.
MedLine Citation:
PMID:  9024147     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Coronary flow reserve (CFR) is reduced in a majority of patients after heart transplantation (HTx). Pharmacological interventions, however, provide only limited information on CFR under physiological conditions. Thus, CFR during exercise was evaluated in the present study. METHODS AND RESULTS: Coronary angiography was performed at rest and during supine bicycle exercise in 35 patients early (2 to 3 months; n = 10) or late (1 to 6 years; mean, 2.5 years; n = 25) after HTx and in 8 controls (C). CFR was determined by parametric imaging after administration of 10 mg intracoronary papaverine, during exercise, and after 1.6 mg sublingual nitroglycerin. Epicardial coronary artery size was measured by quantitative coronary angiography. CFR after papaverine was normal early (3.6 +/- 0.5 versus C, 3.6 +/- 0.7; P = NS) and late (3.8 +/- 1.3 P = NS) after HTx. During exercise, CFR was normal early (3.1 +/- 0.6 versus C, 3.9 +/- 0.9; P = NS) but decreased late (2.3 +/- 0.6; P < .01) after HTx. The increase in coronary cross-sectional area during exercise was also diminished late after HTx (14 +/- 10% versus C, 22 +/- 10%; P < .05). Both exercise-induced CFR (r = -.39, P < .05) and coronary vasodilation (r = -.44, P < .01) were inversely correlated with time after HTx. CONCLUSIONS: CFR during exercise is normal early but reduced late after HTx, whereas CFR after papaverine administration is maintained. This difference between physiological and pharmacological vasodilation suggests progressive endothelial dysfunction after HTx.
G Vassalli; A Gallino; W Kiowski; Z Jiang; M Turina; O M Hess
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation     Volume:  95     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1997 Feb 
Date Detail:
Created Date:  1997-03-11     Completed Date:  1997-03-11     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  607-13     Citation Subset:  AIM; IM    
Department of Internal Medicine, Cardiology, University Hospital, Zurich, Switzerland.
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MeSH Terms
Coronary Angiography
Coronary Circulation* / drug effects
Heart Transplantation*
Middle Aged
Papaverine / diagnostic use
Physical Exertion*
Postoperative Period
Vasodilator Agents / diagnostic use
Vasomotor System / physiopathology
Reg. No./Substance:
0/Vasodilator Agents; 58-74-2/Papaverine

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

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