Microvascular resistance is not influenced by epicardial coronary artery stenosis severity: Experimental validation

The effect of epicardial artery stenosis on myocardial microvascular resistance remains controversial. Recruitable collateral flow, which may affect resistance, was not incorporated into previous measurements. In an open-chest pig model, distal coronary pressure was measured with a pressure wire, an...

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Bibliographic Details
Published in:Circulation (New York, N.Y.) N.Y.), 2004-05, Vol.109 (19), p.2269-2272
Main Authors: FEARON, William F, AARNOUDSE, Wilbert, PIJLS, Nico H. J, DE BRUYNE, Bernard, BALSAM, Leora B, COOKE, David T, ROBBINS, Robert C, FITZGERALD, Peter J, YEUNG, Alan C, YOCK, Paul G
Format: Article
Language:English
Subjects:
Animals
Arterial Occlusive Diseases - physiopathology
Biological and medical sciences
Blood and lymphatic vessels
Cardiology. Vascular system
Collateral Circulation
Coronary Circulation - drug effects
Coronary Stenosis - physiopathology
Diseases of the peripheral vessels. Diseases of the vena cava. Miscellaneous
Medical sciences
Microcirculation - drug effects
Models, Animal
Papaverine - pharmacology
Pericardium
Swine
Vascular Resistance
Vasodilator Agents - pharmacology
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Summary:The effect of epicardial artery stenosis on myocardial microvascular resistance remains controversial. Recruitable collateral flow, which may affect resistance, was not incorporated into previous measurements. In an open-chest pig model, distal coronary pressure was measured with a pressure wire, and the apparent minimal microvascular resistance was calculated during peak hyperemia as pressure divided by flow, measured either with a flow probe around the coronary artery (R(micro app)) or with a novel thermodilution technique (apparent index of microcirculatory resistance [IMR(app)]). These apparent resistances were compared with the actual R(micro) and IMR after the coronary wedge pressure and collateral flow were incorporated into the calculation. Measurements were made at baseline (no stenosis) and after creation of moderate and severe epicardial artery stenoses. In 6 pigs, 189 measurements of R(micro) and IMR were made under the various epicardial artery conditions. Without consideration of collateral flow, R(micro app) (0.43+/-0.12 to 0.46+/-0.10 to 0.51+/-0.11 mm Hg/mL per minute) and IMR(app) (14+/-4 to 17+/-7 to 20+/-10 U) increased progressively and significantly with increasing epicardial artery stenosis (P
ISSN:0009-7322
1524-4539
DOI:10.1161/01.CIR.0000128669.99355.CB