LOSS OF FLOW-DEPENDENT CORONARY-ARTERY DILATATION IN PATIENTS WITH HYPERTENSION

被引:86
作者
ANTONY, I
LEREBOURS, G
NITENBERG, A
机构
[1] CHU XAVIER BICHAT,SERV EXPLORAT FONCT,PARIS,FRANCE
[2] CHU XAVIER BICHAT,INSERM,U251,PARIS,FRANCE
关键词
HYPERTENSION; ARTERIES; BLOOD FLOW; VASODILATION;
D O I
10.1161/01.CIR.91.6.1624
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Abnormal endothelium-dependent coronary response to acetylcholine has been shown in patients with essential hypertension. We tested the hypothesis that flow-dependent dilatation, which has been shown in normal human coronary arteries, is impaired in hypertensive patients. Methods and Results The coronary vasomotor response to maximal increase of blood flow induced by papaverine was studied in 10 control subjects and in 14 hypertensive patients with no other risk factors and angiographically normal coronary arteries. After the injection of papaverine in the midportion of the left anterior descending coronary artery (LAD), the diameter of the proximal LAD (LAD1) was measured by quantitative angiography, whereas that of the proximal circumflex artery (LCx) served as control segment. Estimates of coronary blood flow in the distal LAD (LAD2) were calculated by intracoronary Doppler flow velocity measurements. An increase in LAD2 blood flow of 521+/-41% (P<.001) in control subjects was associated with a 17.0+/-3.3% dilatation of the LAD1 (P<.001) and with no significant change in the diameter of the LCx. In hypertensive patients, despite a comparable increase in LAD2 blood flow of 406+/-32% (P<.001), the LAD1 failed to dilate (-0.4+/-0.6%, NS). The dilative response to isosorbide dinitrate was similar in control subjects and hypertensive patients (30.0+/-4.1%, P<.001 and 21.9+/-1.9%, P<.001, respectively). Conclusions Thus, the flow-mediated coronary dilatation is lost in hypertensive patients, and this may impair normal dilatation observed in response to an increase in myocardial metabolic demand.
引用
收藏
页码:1624 / 1628
页数:5
相关论文
共 29 条
  • [21] ROLE OF ENDOTHELIUM-DERIVED NITRIC-OXIDE IN THE ABNORMAL ENDOTHELIUM-DEPENDENT VASCULAR RELAXATION OF PATIENTS WITH ESSENTIAL-HYPERTENSION
    PANZA, JA
    CASINO, PR
    KILCOYNE, CM
    QUYYUMI, AA
    [J]. CIRCULATION, 1993, 87 (05) : 1468 - 1474
  • [22] FLOW-INDUCED RELEASE OF ENDOTHELIUM-DERIVED RELAXING FACTOR
    RUBANYI, GM
    ROMERO, JC
    VANHOUTTE, PM
    [J]. AMERICAN JOURNAL OF PHYSIOLOGY, 1986, 250 (06): : 1145 - 1149
  • [23] RECOMMENDATIONS REGARDING QUANTITATION IN M-MODE ECHOCARDIOGRAPHY - RESULTS OF A SURVEY OF ECHOCARDIOGRAPHIC MEASUREMENTS
    SAHN, DJ
    DEMARIA, A
    KISSLO, J
    WEYMAN, A
    [J]. CIRCULATION, 1978, 58 (06) : 1072 - 1083
  • [24] Circulation regulatory processes on the large arteries during muscle work.
    Schretzenmayr, A
    [J]. PFLUGERS ARCHIV FUR DIE GESAMTE PHYSIOLOGIE DES MENSCHEN UND DER TIERE, 1933, 232 : 743 - 748
  • [25] DETECTION OF CORONARY ATHEROSCLEROSIS IN YOUNG-ADULT HEARTS USING INTRAVASCULAR ULTRASOUND
    STGOAR, FG
    PINTO, FJ
    ALDERMAN, EL
    FITZGERALD, PJ
    STINSON, EB
    BILLINGHAM, ME
    POPP, RL
    [J]. CIRCULATION, 1992, 86 (03) : 756 - 763
  • [26] HYPERTENSION AND LEFT-VENTRICULAR HYPERTROPHY ARE ASSOCIATED WITH IMPAIRED ENDOTHELIUM-MEDIATED RELAXATION IN HUMAN CORONARY RESISTANCE VESSELS
    TREASURE, CB
    KLEIN, JL
    VITA, JA
    MANOUKIAN, SV
    RENWICK, GH
    SELWYN, AP
    GANZ, P
    ALEXANDER, RW
    [J]. CIRCULATION, 1993, 87 (01) : 86 - 93
  • [27] INTRACORONARY PAPAVERINE - AN IDEAL CORONARY VASODILATOR FOR STUDIES OF THE CORONARY CIRCULATION IN CONSCIOUS HUMANS
    WILSON, RF
    WHITE, CW
    [J]. CIRCULATION, 1986, 73 (03) : 444 - 451
  • [28] CORONARY VASOMOTION IN RESPONSE TO SYMPATHETIC-STIMULATION IN HUMANS - IMPORTANCE OF THE FUNCTIONAL INTEGRITY OF THE ENDOTHELIUM
    ZEIHER, AM
    DREXLER, H
    WOLLSCHLAEGER, H
    SAURBIER, B
    JUST, H
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1989, 14 (05) : 1181 - 1190
  • [29] MODULATION OF CORONARY VASOMOTOR TONE IN HUMANS - PROGRESSIVE ENDOTHELIAL DYSFUNCTION WITH DIFFERENT EARLY STAGES OF CORONARY ATHEROSCLEROSIS
    ZEIHER, AM
    DREXLER, H
    WOLLSCHLAGER, H
    JUST, H
    [J]. CIRCULATION, 1991, 83 (02) : 391 - 401