Document Detail


Vascular reactivity and flow characteristics of radial artery and long saphenous vein coronary bypass grafts: a 5-year follow-up.
MedLine Citation:
PMID:  20713903     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Radial artery (RA) aortocoronary bypass grafts anastomosed to a branch of the circumflex coronary artery have significantly better patency rates than saphenous vein (SV) grafts at 5 years, but the physiological characteristics and mechanisms involved are not clearly defined. We compared RA and SV graft vasomotor and flow responses to endothelium-dependent and -independent stimuli 5 years after surgery in a subgroup of patients enrolled in the Radial artery versus Saphenous Vein Patency (RSVP) trial.
METHODS AND RESULTS: Twenty-seven patients were included in the study (RA, n=15; SV, n=12). Graft blood flow was calculated from flow velocity, measured by intracoronary Doppler, and luminal diameter, measured by quantitative coronary angiography, before and after intragraft infusions of adenosine, acetylcholine, and isosorbide dinitrate. At rest, RA luminal diameters were significantly smaller than SV luminal diameters (P=0.029), blood flow velocity was greater in RA than SV (P=0.008), and volume blood flows were similar. RA but not SV dilated in response to adenosine and isosorbide dinitrate (all P<0.05, RA versus SV, percent change from baseline), and there were no significant differences in the diameter responses to acetylcholine. Volume blood flow responses to adenosine, acetylcholine, and isosorbide dinitrate were comparable.
CONCLUSIONS: Five years after surgery, RA coronary bypass conduits grafted to a single coronary territory demonstrated preserved flow-mediated vasodilatation, whereas SV grafts did not. Our results may provide insight into the more favorable patency of RA grafts over SV grafts.
CLINICAL TRIAL REGISTRATION: http://www.clinicaltrials.gov. Unique identifier: NCT00139399.
Authors:
Carolyn M Webb; Neil E Moat; Chee F Chong; Peter Collins
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Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2010-08-16
Journal Detail:
Title:  Circulation     Volume:  122     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-31     Completed Date:  2010-09-22     Revised Date:  2011-06-06    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  861-7     Citation Subset:  AIM; IM    
Affiliation:
Department of Cardiac Medicine, National Heart and Lung Institute, Imperial College London, UK. c.webb@imperial.ac.uk
Data Bank Information
Bank Name/Acc. No.:
ClinicalTrials.gov/NCT00139399
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MeSH Terms
Descriptor/Qualifier:
Adenosine / diagnostic use
Blood Flow Velocity / drug effects,  physiology
Coronary Angiography
Coronary Artery Bypass / methods*
Coronary Artery Disease / radiography,  surgery*,  ultrasonography
Endothelium, Vascular / physiology
Follow-Up Studies
Humans
Isosorbide Dinitrate / diagnostic use
Radial Artery / transplantation*
Saphenous Vein / transplantation*
Time Factors
Ultrasonography, Interventional
Vascular Patency / drug effects,  physiology
Vascular Resistance / drug effects,  physiology
Vasodilation / drug effects
Vasodilator Agents / diagnostic use
Chemical
Reg. No./Substance:
0/Vasodilator Agents; 58-61-7/Adenosine; 87-33-2/Isosorbide Dinitrate
Comments/Corrections
Comment In:
Circulation. 2011 Apr 19;123(15):e412; author reply e414   [PMID:  21502580 ]
Circulation. 2011 Apr 19;123(15):e413; author reply e414   [PMID:  21502581 ]
Circulation. 2010 Aug 31;122(9):857-8   [PMID:  20713895 ]

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


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