| Temporal increase in resting coronary blood flow causes an impairment of coronary flow reserve after coronary angioplasty. | |
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MedLine Citation:
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PMID: 1729849 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Impaired coronary flow reserve immediately after coronary angioplasty may be attributed to an increase in resting coronary blood flow. To test this hypothesis we measured great cardiac venous flow (GCVF) at rest and during rapid atrial pacing before and immediately after angioplasty in 22 patients with significant narrowing of the left anterior descending artery and 12 patients (control group) with minimal narrowing. A follow-up (6 months) study was also done in seven patients. Immediately after angioplasty the coronary flow reserve (peak GCVF during pacing/resting GCVF) was not fully restored (1.5 +/- 0.36 before angioplasty, 1.76 +/- 0.42 after angioplasty, and 2.13 +/- 0.33 in the control group). Resting coronary vascular resistance (2.4 +/- 0.9 mm Hg/ml/min) was significantly decreased after angioplasty (2.0 +/- 0.8 mm Hg/ml/min), whereas coronary vascular resistance during rapid pacing was fully restored to normal. Resting hyperemia was restored 6 months later, whereas coronary vascular resistance during pacing was unaltered. In five patients, however, slight ischemic ST-T changes were observed during rapid pacing, even after successful angioplasty associated with a decrease in the lactate extraction ratio. These results indicate that the impaired coronary flow reserve immediately after angioplasty may be attributed mainly to the temporal but significant increase in resting coronary flow, although impaired coronary vascular response to augmented myocardial oxygen demand may also be partially involved. |
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Authors:
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S Nanto; K Kodama; M Hori; M Mishima; A Hirayama; M Inoue; T Kamada |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: American heart journal Volume: 123 ISSN: 0002-8703 ISO Abbreviation: Am. Heart J. Publication Date: 1992 Jan |
Date Detail:
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Created Date: 1992-02-11 Completed Date: 1992-02-11 Revised Date: 2007-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0370465 Medline TA: Am Heart J Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 28-36 Citation Subset: AIM; IM |
Affiliation:
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Cardiovascular Division of Kawachi General Hospital, Higashi-osaka, Japan. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Angioplasty, Transluminal, Percutaneous Coronary / adverse effects* Cardiac Pacing, Artificial Coronary Circulation / physiology* Female Follow-Up Studies Hemodynamics Humans Lactates / blood Lactic Acid Male Middle Aged Myocardium / metabolism Oxygen / blood Thermodilution Time Factors Vascular Resistance |
| Chemical | |
Reg. No./Substance:
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0/Lactates; 50-21-5/Lactic Acid; 7782-44-7/Oxygen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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