| Sympathetic stimulation using the cold pressor test increases coronary collateral flow. | |
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MedLine Citation:
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PMID: 11486568 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Little is known about the vasomotor function of human coronary collateral vessels. The purpose of this study was to examine collateral flow under a strong sympathetic stimulus (cold pressor test, CPT). METHODS: In 30 patients (62 +/- 12 years) with coronary artery disease, two subsequent coronary artery occlusions were performed with random CPT during one of them. Two minutes before and during the 1 minute-occlusion, the patient's hand was immerged in ice water. For the calculation of a perfusion pressure-independent collateral flow index (CFI), the aortic (Pao), the central venous (CVP) and the coronary wedge pressure (Poccl) were measured: CFI = (Poccl - CVP)/(Pao - CVP). RESULTS: CPT lead to an increase in Pao from 98 +/- 14 to 105 +/- 15 mm Hg (p = 0.002). Without and with CPT, CFI increased during occlusion from 14% +/- 10% to 16% +/- 10% (p = 0.03) and from 17% +/- 9% to 19% +/- 9% (p = 0.006), respectively, relative to normal flow. During CPT, CFI was significantly higher at the beginning as well as at the end of the occlusion compared to identical instants without CPT. CFI at the end of the control occlusion did not differ significantly from the CFI at the beginning of occlusion with CPT. CONCLUSIONS: During balloon occlusion, collateral flow increased due to collateral recruitment independent of external sympathetic stimulation. Sympathetic stimulation using CPT additionally augmented collateral flow. The collateral-flow-increasing effect of CPT is comparable to the recruitment effect of the occlusion itself. This may reflect a coronary collateral vasodilation mediated by the sympathetic nervous system. |
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Authors:
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S F de Marchi; M Schwerzmann; M Billinger; S Windecker; B Meier; C Seiler |
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Publication Detail:
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Type: Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Swiss medical weekly Volume: 131 ISSN: 1424-7860 ISO Abbreviation: Swiss Med Wkly Publication Date: 2001 Jun |
Date Detail:
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Created Date: 2001-08-06 Completed Date: 2001-12-07 Revised Date: 2011-02-15 |
Medline Journal Info:
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Nlm Unique ID: 100970884 Medline TA: Swiss Med Wkly Country: Switzerland |
Other Details:
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Languages: eng Pagination: 351-6 Citation Subset: IM |
Affiliation:
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Swiss Cardiovascular Center Bern, University Hospital, Bern, Switzerland. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angioplasty, Balloon, Coronary* Aorta / physiopathology Balloon Occlusion* Central Venous Pressure / physiology Cold Temperature* Collateral Circulation / physiology* Coronary Angiography Coronary Artery Disease / physiopathology*, radiography, therapy* Coronary Circulation / physiology* Electrocardiography Female Heart Rate / physiology Humans Male Middle Aged Physical Stimulation Pulmonary Wedge Pressure / physiology Sympathetic Nervous System / physiopathology* Vasodilation / physiology* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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