Minimally invasive evaluation of coronary microvascular function by electron beam computed tomography.

نویسندگان

  • S Möhlenkamp
  • L O Lerman
  • A Lerman
  • T R Behrenbeck
  • Z S Katusić
  • P F Sheedy
  • E L Ritman
چکیده

BACKGROUND We previously demonstrated that in vivo electron-beam computed tomography (EBCT)-based indicator-dilution methods provide an estimate of intramyocardial blood volume (BV) and perfusion (F), which relate as BV=aF+b radicalF, where a characterizes the recruitable (exchange) and b the nonrecruitable (conduit) component of the myocardial microcirculation. In the present study, we compared BV and F with intracoronary Doppler ultrasound-based coronary blood flow (CBF) as a method for detecting and quantifying differential responses of these microvascular components to vasoactive drugs in normal (control) and hypercholesterolemic (HC) pigs. METHODS AND RESULTS BV and F values were obtained from contrast-enhanced EBCT studies in 14 HC and 14 control pigs. BV, F, and CBF values were obtained at baseline (intracoronary infusion of saline) and after 5 minutes each of intracoronary infusion of adenosine (100 microgram. kg(-1). min(-1)) and nitroglycerin (40 microgram/min). BV and CBF reserves in response to adenosine were attenuated in HC pigs compared with controls (90+/-36% versus 127+/-42%, P<0.03, and 485+/-182% versus 688+/-160%, P<0.01, respectively). The relationship between BV and F showed consistently lower recruitable BV in HC versus control pigs. Nonrecruitable BV reserve in response to adenosine was attenuated in HC compared with controls (77+/-20% versus 135+/-28%, P<0.001). Our findings are consistent with HC-induced impairment of intramyocardial resistance vessel function. CONCLUSIONS EBCT technology allows minimally invasive evaluation of intramyocardial microcirculatory function and permits assessment of microvascular BV distribution in different functional components. This method may be of value in evaluating the coronary microcirculation in pathophysiological states such as hypercholesterolemia.

برای دانلود رایگان متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Coronary atherosclerosis and its effect on cardiac structure and function: evaluation by electron beam computed tomography.

Coronary artery disease affects millions of Americans annually. In evaluating coronary artery disease, it is important to develop diagnostic methodology that can screen patients before the onset of symptoms or cardiac events and, in addition, evaluate the functional aspects of coronary artery disease, including any residual effects on the heart after events have occurred. Electron beam computed...

متن کامل

Non-invasive coronary artery imaging with electron beam computed tomography and magnetic resonance imaging.

متن کامل

Assessment of cardiac function using multidetector row computed tomography.

In patients with suspected or documented heart disease, a precise quantitative and qualitative assessment of cardiac function is critical for clinical diagnosis, risk stratification, management and prognosis. Cardiac CT is increasingly being used in diagnosis of coronary artery disease. Initially multi-detector row computed tomography (MDCT) was used chiefly for detecting coronary artery stenos...

متن کامل

Contrast enhanced electron beam computed tomography to analyse the coronary arteries in patients after acute myocardial infarction.

OBJECTIVE To evaluate the accuracy of contrast enhanced electron beam computed tomography (EBCT) after acute myocardial infarction in determining patency of the infarct related artery and detecting high grade stenoses and occlusions in the coronary vessels. DESIGN Case study using blinded comparison with invasive coronary angiography. PATIENTS 36 patients (mean age 53 years) 4-70 days after...

متن کامل

Non-invasive assessment of the risk of coronary heart disease.

OBJECTIVE Non-invasive evaluations for the presence of coronary heart disease (CHD) are being done with increasing frequency in clinical medicine and as part of the risk selection process for life insurance. The predictive value of testing depends on the pretest probability of disease and the sensitivity and specificity of the testing used. This paper reviews the accuracy of exercise treadmill ...

متن کامل

ذخیره در منابع من

ذخیره در منابع من قبلا به منابع من ذحیره شده

{@ msg_add @}


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

عنوان ژورنال:
  • Circulation

دوره 102 19  شماره 

صفحات  -

تاریخ انتشار 2000