Document Detail


Simultaneous intracoronary ultrasound and Doppler flow studies distinguish flow-mediated from receptor-mediated endothelial responses.
MedLine Citation:
PMID:  10348123     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Abnormalities in vascular endothelial function, which occur early in atherosclerosis, may play an etiologic role in the development of the disease or represent a marker for the extent of atherosclerosis. Endothelial dysfunction, usually characterized by demonstration of decreased endothelium-dependent vasorelaxation, may be a sensitive and specific method to detect vascular disease in its earliest stages. In this context, separation of abnormalities in receptor-mediated and flow-mediated endothelium-dependent vasodilatory responses may allow for the most accurate characterization of endothelial dysfunction. In 35 patients undergoing routine annual cardiac catheterization after heart transplantation, changes in epicardial lumen area and coronary blood flow in response to intracoronary administration of adenosine, acetylcholine, and nitroglycerin were measured simultaneously using an intravascular ultrasound (IVUS) catheter positioned over a Doppler flow wire in the left anterior descending coronary artery. The combination of these techniques allowed for distinction between receptor-mediated and flow-mediated endothelium-dependent vascular responses. Peak flow with the endothelium-independent resistance vessel dilator adenosine occurred at 18+/-2 sec; the maximal lumen area response occurred later, at 43+/-11 sec (P < 0.001). Acetylcholine, an endothelium-dependent small- and large-vessel vasodilator, caused an immediate increase in both flow and lumen area, but a second peak of dilation was observed, and maximal area occurred 46 sec after maximal flow (54+/-14 vs. 100+/-26 sec, P < 0.001). Simultaneous IVUS and Doppler flow measurements after infusion of vasoactive agents allows for distinction between and evaluation of the relative contribution of agonist-mediated and flow-mediated responses, which may offer important and unique insights into coronary endothelial function.
Authors:
S M Hollenberg; P Tamburro; M R Johnson; D E Burns; D Spokas; M R Costanzo; J E Parrillo; L W Klein
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions     Volume:  46     ISSN:  1522-1946     ISO Abbreviation:  Catheter Cardiovasc Interv     Publication Date:  1999 Mar 
Date Detail:
Created Date:  1999-07-06     Completed Date:  1999-07-06     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  100884139     Medline TA:  Catheter Cardiovasc Interv     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  282-8     Citation Subset:  IM    
Affiliation:
Section of Cardiology, Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois 60612, USA. shollenb@rpslmc.edu
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MeSH Terms
Descriptor/Qualifier:
Acetylcholine / pharmacology
Adenosine / pharmacology
Adult
Arteriosclerosis / physiopathology*,  ultrasonography
Blood Flow Velocity
Coronary Vessels / physiopathology*
Endothelium, Vascular / physiology*
Female
Heart Catheterization
Heart Transplantation
Hemodynamics / drug effects
Humans
Male
Middle Aged
Postoperative Period
Receptors, Muscarinic / physiology*
Regional Blood Flow / physiology
Ultrasonography, Interventional*
Vasodilation / physiology*
Vasodilator Agents / pharmacology
Chemical
Reg. No./Substance:
0/Receptors, Muscarinic; 0/Vasodilator Agents; 51-84-3/Acetylcholine; 58-61-7/Adenosine
Comments/Corrections
Comment In:
Catheter Cardiovasc Interv. 1999 Mar;46(3):289-91   [PMID:  10348124 ]

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


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