Document Detail


Temporal relation of changes in regional coronary flow and myocardial lactate and nucleoside metabolism during pacing-induced ischemia.
MedLine Citation:
PMID:  3788806     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The temporal relation between myocardial lactate and hypoxanthine metabolism and regional changes in krypton-81m perfusion during pacing-induced ischemia was studied in 17 patients with coronary artery disease (CAD). During incremental atrial pacing, lactate production and hypoxanthine release occurred early and simultaneously, accompanied by ST-segment changes, but before angina and only few minutes after a significant (17%) reduction in krypton-81m perfusion in areas with more than 90% luminal diameter reduction. During maximal pacing heart rates, krypton-81m distribution decreased to 68 +/- 7% of control in areas with more than 90% diameter reduction and to 80 +/- 4% in 70 to 90% reduction (both p less than 0.05 vs control). Maximal lactate production occurred 15 seconds after pacing (extraction -15 +/- 7% vs 16 +/- 2% during control, p less than 0.05) and peak hypoxanthine release 1 minute after pacing (delta arteriovenous -2.64 +/- 0.8 microM vs 0.08 +/- 0.21 microM during control, p less than 0.05). Krypton-81m perfusion decreased in 20 of the 21 CAD areas. Angina, ST-segment changes, hemodynamic alterations and lactate production occurred in 15, 14, 9 and 15 patients, respectively. In contrast, hypoxanthine release was found in all cases. After pacing, lactate production and all general indexes of ischemia persisted for only 2 to 3 minutes. In contrast, krypton-81m perfusion was still significantly reduced 5 minutes after pacing and was only accompanied by hypoxanthine release (delta arteriovenous -1.41 +/- 0.6 microM, p less than 0.05 vs control).(ABSTRACT TRUNCATED AT 250 WORDS)
Authors:
W J Remme; R van den Berg; M Mantel; P H Cox; D C van Hoogenhuyze; X H Krauss; C J Storm; D A Kruyssen
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The American journal of cardiology     Volume:  58     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1986 Dec 
Date Detail:
Created Date:  1987-01-14     Completed Date:  1987-01-14     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1188-94     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Cardiac Pacing, Artificial*
Coronary Circulation*
Coronary Disease / physiopathology*
Female
Humans
Hypoxanthine
Hypoxanthines / metabolism*
Krypton / diagnostic use
Lactates / metabolism*
Lactic Acid
Male
Middle Aged
Myocardium / metabolism*
Radioisotopes / diagnostic use
Chemical
Reg. No./Substance:
0/Hypoxanthines; 0/Lactates; 0/Radioisotopes; 50-21-5/Lactic Acid; 68-94-0/Hypoxanthine; 7439-90-9/Krypton

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