Relation between regional function and coronary blood flow reserve in multivessel coronary artery stenosis

Jian Ping Bin, Robert A. Pelberg, Kevin Wei, Matthew Coggins, N. Craig Goodman, Sanjiv Kaul

Research output: Contribution to journalArticlepeer-review

11 Scopus citations

Abstract

In the setting of chronic coronary stenoses, percent wall thickening (%WT) both at rest and during catecholamine stimulation can be abnormal despite normal resting myocardial blood flow (MBF). We hypothesized that this phenomenon is related to abnormal MBF reserve. Accordingly, 15 dogs were studied between 7 and 10 days after placement of Ameroid constrictors around the proximal coronary arteries and their major branches, at a time when collateral development had not yet occurred. %WT and MBF were measured at rest, after 0.56 mg/kg of dipyridamole, and at incremental doses of dobutamine (5-40 μg·kg-1·min-1). Resting %WT and MBF were normal in all four sham dogs. Resting transmural MBF was normal in all segments in the 11 study dogs, despite reduced (-2 SD of normal) %WT (<30%) in 40 of 82 segments. MBF reserve was reduced (<3) in segments with reduced %WT, and a close coupling was noted between resting %WT and MBF reserve. All segments showed an increase in %WT with dobutamine up to a dose of 20 μg·kg-1·min-1, above which those with abnormal endocardial MBF reserve showed a 'biphasic' response. It is concluded that, in the presence of chronic coronary stenoses, abnormalities in resting %WT as well as inducible reduction in %WT during pharmacological stress are related to the degree of abnormal MBF reserve.

Original languageEnglish (US)
Pages (from-to)H3058-H3064
JournalAmerican Journal of Physiology - Heart and Circulatory Physiology
Volume279
Issue number6 48-6
DOIs
StatePublished - 2000
Externally publishedYes

Keywords

  • Dobutamine echocardiography
  • Resting regional dysfunction

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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