Microvascular dysfunction in collateral-dependent myocardium.

Abstract:

OBJECTIVES:The aim of this study was to evaluate myocardial blood flow regulation in collateral-dependent myocardium of patients with coronary artery disease. BACKGROUND:Despite great clinical relevance, perfusion correlates of collateral circulation in humans have rarely been estimated by quantitative methods at rest and during stress. METHODS:Nineteen patients with angina and isolated occlusion of the left anterior descending (n = 14) or left circumflex (n = 5) coronary artery were evaluated. Using positron emission tomography and nitrogen-13 ammonia, we obtained flow measurements at baseline, during atrial pacing-induced tachycardia and after intravenous administration of dipyridamole (0.56 mg/kg body weight over 4 min). Flow values in collateral-dependent and remote areas were compared with values in 13 normal subjects. RESULTS:Flow at rest was similar in collateralized and remote myocardium (0.61 +/- 0.11 vs. 0.63 +/- 0.17 ml/min per g, mean +/- 1 SD), and both values were lower than normal (1.00 +/- 0.20 ml/min per g, p < 0.01). During pacing, blood flow increased to 0.83 +/- 0.25 and 1.11 +/- 0.39 ml/min per g in collateral-dependent and remote areas, respectively (p < 0.05 vs. baseline); both values were lower than normal (1.86 +/- 0.61 ml/min per g, p < 0.01). Dipyridamole induced a further increase in perfusion in remote areas (1.36 +/- 0.57 ml/min per g, p < 0.01 vs. pacing) but not in collateral-dependent regions (0.93 +/- 0.37 ml/min per g, p = NS vs. pacing); again, both values were lower (p < 0.01) than normal (3.46 +/- 0.78 ml/min per g). Dipyridamole flow in collateral-dependent myocardium was slightly lower in patients with poorly developed than in those with well developed collateral channels (0.75 +/- 0.29 vs. 1.06 +/- 0.38 ml/min per g, respectively, p = 0.06); however, the former showed higher flow inhomogeneity (collateral/control flow ratio 0.58 +/- 0.10 vs. 0.81 +/- 0.22, respectively, p < 0.02). A linear direct correlation was observed between flow reserve of collateral-dependent and remote regions (r = 0.83, p < 0.01). CONCLUSIONS:Despite rest hypoperfusion, collateral-dependent myocardium maintains a vasodilator reserve that is almost fully utilized during increases in oxygen consumption. A global microvascular disorder might hamper adaptation to chronic coronary occlusion.

journal_name

J Am Coll Cardiol

authors

Sambuceti G,Parodi O,Giorgetti A,Salvadori P,Marzilli M,Dabizzi P,Marzullo P,Neglia D,L'Abbate A

doi

10.1016/0735-1097(95)00209-M

subject

Has Abstract

pub_date

1995-09-01 00:00:00

pages

615-23

issue

3

eissn

0735-1097

issn

1558-3597

pii

0735-1097(95)00209-M

journal_volume

26

pub_type

杂志文章
  • Bradycardia and syncope as manifestations of partial epilepsy.

    abstract::Although transient increases in heart rate typically occur, bradycardia has infrequently been noted in association with partial seizures. Five patients with temporal lobe epilepsy are described in whom sinus bradyarrhythmias and syncope were prominent manifestations of seizure activity. Partial improvement occurred in...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章

    doi:10.1016/0735-1097(90)90290-6

    authors: Constantin L,Martins JB,Fincham RW,Dagli RD

    更新日期:1990-03-15 00:00:00

  • Functional capacity after cardiac surgery in elderly patients.

    abstract:OBJECTIVES:This study was performed to determine whether cardiac surgery improves functional capacity in patients > 70 years of age and to identify factors associated with good and poor functional results in this age group. BACKGROUND:Cardiac surgery has been used increasingly among older patients, but the effectivene...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章

    doi:10.1016/0735-1097(94)90548-7

    authors: Jaeger AA,Hlatky MA,Paul SM,Gortner SR

    更新日期:1994-07-01 00:00:00

  • Challenges in the Design and Interpretation of Noninferiority Trials: Insights From Recent Stent Trials.

    abstract::The noninferiority design is used extensively in current clinical research, but its complex features may hamper the appropriate interpretation of such trials. Thus, understanding the pillars of noninferiority design is indispensable. The authors discuss fundamental concepts regarding the design and interpretation of n...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章,评审

    doi:10.1016/j.jacc.2017.06.039

    authors: Macaya F,Ryan N,Salinas P,Pocock SJ

    更新日期:2017-08-15 00:00:00

  • Treatment of obstructive sleep apnea reduces the risk of atrial fibrillation recurrence after catheter ablation.

    abstract:OBJECTIVES:The aim of this study was to examine the effect of continuous positive airway pressure (CPAP) therapy on atrial fibrillation (AF) recurrence in patients with obstructive sleep apnea (OSA) undergoing pulmonary vein isolation (PVI). BACKGROUND:OSA is a predictor of AF recurrence following PVI. However, the im...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章

    doi:10.1016/j.jacc.2013.03.052

    authors: Fein AS,Shvilkin A,Shah D,Haffajee CI,Das S,Kumar K,Kramer DB,Zimetbaum PJ,Buxton AE,Josephson ME,Anter E

    更新日期:2013-07-23 00:00:00

  • Subclinical peripheral arterial disease and incompressible ankle arteries are both long-term prognostic factors in patients undergoing coronary artery bypass grafting.

    abstract:OBJECTIVES:This study was designed to determine the prevalence of peripheral arterial disease (PAD) in candidates for coronary artery bypass grafting (CABG) and to assess the predictive value of different types of subclinical PAD (peripheral occlusive disease and medial arterial calcification [incompressible ankle arte...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章

    doi:10.1016/j.jacc.2005.05.066

    authors: Aboyans V,Lacroix P,Postil A,Guilloux J,Rollé F,Cornu E,Laskar M

    更新日期:2005-09-06 00:00:00

  • Focal atrial tachycardia arising from the mitral annulus: electrocardiographic and electrophysiologic characterization.

    abstract:OBJECTIVES:The study was done to characterize the electrocardiographic and electrophysiologic features of focal atrial tachycardia originating at the mitral annulus (MA). BACKGROUND:Though the majority of left atrial tachycardias originate around the ostia of the pulmonary veins, only isolated reports have described f...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章

    doi:10.1016/s0735-1097(03)00484-4

    authors: Kistler PM,Sanders P,Hussin A,Morton JB,Vohra JK,Sparks PB,Kalman JM

    更新日期:2003-06-18 00:00:00

  • Diagnosis of spontaneous coronary artery dissection by optical coherence tomography.

    abstract:OBJECTIVES:This study sought to assess the diagnostic value of optical coherence tomography (OCT) in patients with suspected spontaneous coronary artery dissection (SCAD). BACKGROUND:SCAD is a rare but challenging clinical entity. METHODS:Following a prospective protocol, OCT was performed in 17 consecutive patients ...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章

    doi:10.1016/j.jacc.2011.08.082

    authors: Alfonso F,Paulo M,Gonzalo N,Dutary J,Jimenez-Quevedo P,Lennie V,Escaned J,Bañuelos C,Hernandez R,Macaya C

    更新日期:2012-03-20 00:00:00

  • Pharmacology of platelet inhibitors.

    abstract::Although many drugs have inhibitory effects on platelet function, none of them inhibits all of the mechanisms that may be involved in the various forms of thrombosis. Choice of suitable drugs is hampered by lack of full knowledge concerning the reactions that make the major contributions to the formation of arterial t...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章,评审

    doi:10.1016/s0735-1097(86)80004-3

    authors: Harker LA,Fuster V

    更新日期:1986-12-01 00:00:00

  • Doppler echocardiographic demonstration of the differential effects of right ventricular pressure and volume overload on left ventricular geometry and filling.

    abstract::To compare the effects of isolated right ventricular pressure and volume overload on left ventricular diastolic geometry and filling, 11 patients with primary pulmonary hypertension, 11 patients with severe tricuspid regurgitation due to tricuspid valve resection and 11 normal subjects were studied with use of Doppler...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章

    doi:10.1016/0735-1097(92)90056-s

    authors: Louie EK,Rich S,Levitsky S,Brundage BH

    更新日期:1992-01-01 00:00:00

  • Medical Therapy With Versus Without Revascularization in Stable Patients With Moderate and Severe Ischemia: The Case for Community Equipoise.

    abstract::All patients with stable ischemic heart disease (SIHD) should be managed with guideline-directed medical therapy (GDMT), which reduces progression of atherosclerosis and prevents coronary thrombosis. Revascularization is also indicated in patients with SIHD and progressive or refractory symptoms, despite medical manag...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章,评审

    doi:10.1016/j.jacc.2015.09.056

    authors: Stone GW,Hochman JS,Williams DO,Boden WE,Ferguson TB Jr,Harrington RA,Maron DJ

    更新日期:2016-01-05 00:00:00

  • Physiological Stress Elicits Impaired Left Ventricular Function in Preterm-Born Adults.

    abstract:BACKGROUND:Experimental and clinical studies show that prematurity leads to altered left ventricular (LV) structure and function with preserved resting LV ejection fraction (EF). Large-scale epidemiological data now links prematurity to increased early heart failure risk. OBJECTIVES:The authors performed echocardiogra...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章

    doi:10.1016/j.jacc.2018.01.046

    authors: Huckstep OJ,Williamson W,Telles F,Burchert H,Bertagnolli M,Herdman C,Arnold L,Smillie R,Mohamed A,Boardman H,McCormick K,Neubauer S,Leeson P,Lewandowski AJ

    更新日期:2018-03-27 00:00:00

  • Coronary Calcium Score and Cardiovascular Risk.

    abstract::Coronary artery calcium (CAC) is a highly specific feature of coronary atherosclerosis. On the basis of single-center and multicenter clinical and population-based studies with short-term and long-term outcomes data (up to 15-year follow-up), CAC scoring has emerged as a widely available, consistent, and reproducible ...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章,评审

    doi:10.1016/j.jacc.2018.05.027

    authors: Greenland P,Blaha MJ,Budoff MJ,Erbel R,Watson KE

    更新日期:2018-07-24 00:00:00

  • Association of contemporary sensitive troponin I levels at baseline and change at 1 year with long-term coronary events following myocardial infarction or unstable angina: results from the LIPID Study (Long-Term Intervention With Pravastatin in Ischaemic

    abstract:OBJECTIVES:This study sought to assess whether baseline and change in contemporary sensitive troponin I (TnI) levels predicts coronary heart disease (CHD) death and myocardial infarction (MI), and to determine the effects of pravastatin on TnI levels. BACKGROUND:The role of troponins in predicting long-term outcomes i...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章,随机对照试验

    doi:10.1016/j.jacc.2013.08.1643

    authors: White HD,Tonkin A,Simes J,Stewart R,Mann K,Thompson P,Colquhoun D,West M,Nestel P,Sullivan D,Keech AC,Hunt D,Blankenberg S,LIPID Study Investigators.

    更新日期:2014-02-04 00:00:00

  • "Ischemia at a distance" during intermittent coronary artery occlusion: a coronary anatomic explanation.

    abstract::The mechanism of electrocardiographic ST segment changes during acute coronary occlusion was evaluated in 28 consecutive patients with single vessel coronary artery disease undergoing coronary angioplasty. Patients were continuously monitored with a six lead electrocardiogram. Twenty-three patients showed ST changes i...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章

    doi:10.1016/s0735-1097(85)80250-3

    authors: Brymer JF,Khaja F,Marzilli M,Goldstein S

    更新日期:1985-07-01 00:00:00

  • Increased release of nitric oxide in ischemic hearts after exercise in patients with effort angina.

    abstract:OBJECTIVES:The aim of this study was to determine whether the release of nitric oxide (NO) from the ischemic heart increases during exercise in patients with effort angina. BACKGROUND:Myocardial ischemia increases NO production in the canine heart, but no such increase has been demonstrated in the ischemic human heart...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章

    doi:10.1016/s0735-1097(98)00196-x

    authors: Node K,Kitakaze M,Sato H,Koretsune Y,Karita M,Kosaka H,Hori M

    更新日期:1998-07-01 00:00:00

  • Evaluation of acute dual-chamber pacing with a range of atrioventricular delays on cardiac performance in refractory heart failure.

    abstract:OBJECTIVES:This study evaluated how variations in atrioventricular (AV) delay affect hemodynamic function in patients with refractory heart failure being supported with intravenous inotropic and intravenous or oral inodilating agents. BACKGROUND:Although preliminary data have suggested that dual-chamber pacing with sh...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章

    doi:10.1016/s0735-1097(97)00307-0

    authors: Shinbane JS,Chu E,DeMarco T,Sobol Y,Fitzpatrick AP,Lau DM,Klinski C,Schiller NB,Griffin JC,Chatterjee K

    更新日期:1997-11-01 00:00:00

  • Ventricular response to atrial fibrillation: role of atrioventricular conduction pathways.

    abstract::Irregularity of the ventricular rhythm is a hallmark of patients with atrial fibrillation, yet the genesis of the irregularity is not yet fully understood. The role of the atrioventricular (AV) node in determining the irregularity of the ventricular response to atrial fibrillation was investigated by comparing the fre...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章

    doi:10.1016/0735-1097(88)92610-1

    authors: Kirsh JA,Sahakian AV,Baerman JM,Swiryn S

    更新日期:1988-11-01 00:00:00

  • Quantitative assessment of myocardial perfusion during graded coronary stenosis by real-time myocardial contrast echo refilling curves.

    abstract:OBJECTIVES:The present study examined the ability of real-time myocardial contrast echocardiography (MCE) to delineate abnormalities produced by graded coronary stenoses and to correlate signal intensity (SI) parameters derived from destruction/refilling curves with regional myocardial blood flow (MBF) and contractile ...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章

    doi:10.1016/s0735-1097(00)01046-9

    authors: Masugata H,Peters B,Lafitte S,Strachan GM,Ohmori K,DeMaria AN

    更新日期:2001-01-01 00:00:00

  • Differential effects of antihypertensive treatment on left ventricular diastolic function: an ASCOT (Anglo-Scandinavian Cardiac Outcomes Trial) substudy.

    abstract:OBJECTIVES:We hypothesized that an amlodipine-based regimen would have more favorable effects on left ventricular (LV) diastolic function. BACKGROUND:Different antihypertensive therapies may vary in their effect on LV diastolic function. METHODS:The HACVD (Hypertension Associated Cardiovascular Disease) substudy of A...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章

    doi:10.1016/j.jacc.2009.11.084

    authors: Tapp RJ,Sharp A,Stanton AV,O'Brien E,Chaturvedi N,Poulter NR,Sever PS,Thom SA,Hughes AD,Mayet J,ASCOT Investigators.

    更新日期:2010-04-27 00:00:00

  • Silent ischemia during coronary occlusion produced by balloon inflation: relation to regional myocardial dysfunction.

    abstract::Thirty patients with stable exertional angina undergoing percutaneous transluminal coronary angioplasty of an isolated obstructive lesion of the proximal left anterior descending artery were prospectively evaluated to investigate the relation between angina induced by balloon inflation and the quantity and severity of...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章

    doi:10.1016/s0735-1097(87)80189-4

    authors: Wohlgelernter D,Jaffe CC,Cabin HS,Yeatman LA Jr,Cleman M

    更新日期:1987-09-01 00:00:00

  • Colchicine and antineoplastic therapy for the prevention of restenosis after percutaneous coronary interventions.

    abstract::The complexity of the events that culminate in intimal proliferation after arterial injury and similarities between this response and benign neoplasia suggest that conventional medical therapies will continue to be unsuccessful in preventing recurrent stenosis after percutaneous coronary revascularization. By preventi...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章,评审

    doi:10.1016/0735-1097(91)90948-9

    authors: Muller DW,Ellis SG,Topol EJ

    更新日期:1991-05-01 00:00:00

  • Reduced Cardiac Index Is Not the Dominant Driver of Renal Dysfunction in Heart Failure.

    abstract:BACKGROUND:It is widely believed that a reduced cardiac index (CI) is a significant contributor to renal dysfunction in patients with heart failure (HF). However, recent data have challenged this paradigm. OBJECTIVES:This study sought to determine the relationship between CI and renal function in a multicenter populat...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1016/j.jacc.2016.02.058

    authors: Hanberg JS,Sury K,Wilson FP,Brisco MA,Ahmad T,Ter Maaten JM,Broughton JS,Assefa M,Tang WHW,Parikh CR,Testani JM

    更新日期:2016-05-17 00:00:00

  • Variability of individual platelet reactivity over time in patients treated with clopidogrel: insights from the ELEVATE-TIMI 56 trial.

    abstract:BACKGROUND:The degree of antiplatelet response to clopidogrel has been associated with clinical outcomes. Studies have investigated whether adjustment of antiplatelet therapies based on a single platelet function test is beneficial. OBJECTIVES:The aim of the study was to test the stability of platelet reactivity measu...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1016/j.jacc.2014.03.051

    authors: Hochholzer W,Ruff CT,Mesa RA,Mattimore JF,Cyr JF,Lei L,Frelinger AL 3rd,Michelson AD,Berg DD,Angiolillo DJ,O'Donoghue ML,Sabatine MS,Mega JL

    更新日期:2014-07-29 00:00:00

  • Remodeling of the aorta after successful balloon coarctation angioplasty.

    abstract::The purpose of this study was to examine whether remodeling of the aorta takes place after successful balloon angioplasty of aortic coarctation. During the 35 month period ending in December 1987, 30 children, aged 14 days to 13 years, underwent balloon angioplasty of unoperated aortic coarctation, with a resultant re...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章

    doi:10.1016/0735-1097(89)90434-8

    authors: Rao PS,Carey P

    更新日期:1989-11-01 00:00:00

  • The effects of continuous positive airway pressure on myocardial energetics in patients with heart failure and obstructive sleep apnea.

    abstract:OBJECTIVES:We sought to examine the short-term and longer term (6-week) effects of continuous positive airway pressure (CPAP) on myocardial energetics. BACKGROUND:Obstructive sleep apnea (OSA) and heart failure (HF) are both states of increased afterload and metabolic demand. Treatment with CPAP may initially reduce s...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章

    doi:10.1016/j.jacc.2006.08.059

    authors: Yoshinaga K,Burwash IG,Leech JA,Haddad H,Johnson CB,deKemp RA,Garrard L,Chen L,Williams K,DaSilva JN,Beanlands RS

    更新日期:2007-01-30 00:00:00

  • Evaluation of QT interval duration and dispersion and proposed clinical criteria in diagnosis of long QT syndrome in patients with a genetically uniform type of LQT1.

    abstract:OBJECTIVES:This study investigated the ability of QT duration, QT dispersion (QTD) and clinical diagnostic criteria to correctly identify genetically documented LQT1 type long QT syndrome (LQTS) patients, and to separate symptomatic and asymptomatic LQT1 patients. BACKGROUND:Ventricular repolarization has played an es...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章

    doi:10.1016/s0735-1097(98)00248-4

    authors: Swan H,Saarinen K,Kontula K,Toivonen L,Viitasalo M

    更新日期:1998-08-01 00:00:00

  • The World Trade Center attack: increased frequency of defibrillator shocks for ventricular arrhythmias in patients living remotely from New York City.

    abstract:OBJECTIVES:The goal of this study was to determine whether the World Trade Center (WTC) attack on September 11, 2001, had an effect on the occurrence of ventricular arrhythmias among patients with implantable cardioverter-defibrillators (ICDs) living in Florida. BACKGROUND:Increased frequencies of ICD therapies for ve...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章

    doi:10.1016/j.jacc.2004.04.058

    authors: Shedd OL,Sears SF Jr,Harvill JL,Arshad A,Conti JB,Steinberg JS,Curtis AB

    更新日期:2004-09-15 00:00:00

  • Mapping of regional myocardial strain and work during ventricular pacing: experimental study using magnetic resonance imaging tagging.

    abstract:OBJECTIVES:The purpose of this study was to determine the spatial distribution of myocardial function (myofiber shortening and work) within the left ventricular (LV) wall during ventricular pacing. BACKGROUND:Asynchronous electrical activation, as induced by ventricular pacing, causes various abnormalities in LV funct...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章

    doi:10.1016/s0735-1097(99)00068-6

    authors: Prinzen FW,Hunter WC,Wyman BT,McVeigh ER

    更新日期:1999-05-01 00:00:00

  • N-2-mercaptopropionylglycine improves recovery of myocardial function after reversible regional ischemia.

    abstract::Myocardial reperfusion after reversible regional ischemia is known to result in delayed recovery of contractile function, but the mechanism responsible for this phenomenon remains unclear. We examined the ability of N-2-mercaptopropionylglycine, a synthetic thiol compound with oxygen free radical scavenging properties...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章

    doi:10.1016/s0735-1097(86)80396-5

    authors: Myers ML,Bolli R,Lekich RF,Hartley CJ,Roberts R

    更新日期:1986-11-01 00:00:00

  • Data for cardiovascular modeling.

    abstract::Data are required for a meaningful approach to quality and cost-conscious cardiovascular care. How to identify the types of data available and their sources, advantages and limitations to their use, issues involved in combining data from different sources for decision modeling and some possible solutions are discussed...

    journal_title:Journal of the American College of Cardiology

    pub_type: 杂志文章

    doi:10.1016/0735-1097(89)90166-6

    authors: Muhlbaier LH,Pryor DB

    更新日期:1989-09-01 00:00:00