Document Detail


The effect of rapid decreases of blood pressure by different mechanisms on coronary flow and flow reserve in normal coronary arteries.
MedLine Citation:
PMID:  14643572     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Changes in mean blood pressure (MBP) alter coronary blood flow (CBF). We evaluated the acute effects of three hypotensive medications on CBF parameters in angiographically normal coronary arteries. METHODS: We performed CBF measurements using the Doppler wire at rest and during hyperemia produced by intracoronary adenosine (18 microg) as follows: 1) in the normal left circumflex coronary artery in 20 patients with coronary artery disease (measurements were performed without drugs, and after intravenous infusion of nitroprusside [0.5 to 2 microg/kg/min] and nitroglycerin [10 to 90 microg/min]; drugs were titrated to decrease MBP 20% to 25% below the control values, and heart rate was held constant using right atrial pacing); and 2) in the normal left anterior descending coronary artery in 19 patients without coronary artery disease (measurements were performed before and after intravenous clonidine infusion [150 microg in 5 min]; time-averaged peak velocity [APV], CBF, and coronary flow reserve [CFR] were measured). RESULTS: Similar decreases in MBP were obtained in the two patient groups. Lumen diameter at the site of Doppler measurements increased after all medications (P <.005), whereas CBF did not change significantly. The CFR decreased after nitroprusside (1.79 +/- 0.48 v 2.54 +/- 0.45, P=.000), did not change significantly after nitroglycerin (2.74 +/- 0.43 v 2.54 +/- 0.45, P =.097), and increased after clonidine (3.12 +/- 0.70 v 2.76 +/- 0.75, P =.006). CONCLUSIONS: In normal coronary arteries the infusion of three hypotensive medications to produce the same decreases in MBP is associated with different effects on CFR (increase with clonidine, decrease with nitroprusside, and no change with nitroglycerin).
Authors:
Vassilis Voudris; Dimitrios Avramides; Plamen Gatzov; John Malakos; John Skoularigis; Athanassios Manolis; Haralambos Gavras; Irene Gavras; Dennis V Cokkinos
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of hypertension     Volume:  16     ISSN:  0895-7061     ISO Abbreviation:  Am. J. Hypertens.     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2003-12-03     Completed Date:  2004-04-13     Revised Date:  2009-02-24    
Medline Journal Info:
Nlm Unique ID:  8803676     Medline TA:  Am J Hypertens     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1000-5     Citation Subset:  IM    
Affiliation:
1st Cardiology Department, Onassis Cardiac Surgery Center, Athens, Greece. vvoudris@otenet.gr
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MeSH Terms
Descriptor/Qualifier:
Aged
Antihypertensive Agents / pharmacology*
Blood Flow Velocity / drug effects
Blood Pressure / drug effects*
Clonidine / pharmacology*
Coronary Artery Disease / physiopathology
Coronary Circulation / drug effects*
Coronary Vessels / drug effects
Female
Humans
Male
Middle Aged
Nitroglycerin / pharmacology*
Nitroprusside / pharmacology*
Chemical
Reg. No./Substance:
0/Antihypertensive Agents; 15078-28-1/Nitroprusside; 4205-90-7/Clonidine; 55-63-0/Nitroglycerin

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


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