Coronary stenosis vasomotion during dynamic exercise before and after PTCA

Abstract

KEY WORDS: Coronary artery disease, coronary vasomotion, percutaneous transluminal coronary angioplasty, supine bicycle exercise. Normal coronary arteries showed a minimal increase in mean luminal area before (+2%; NS) as well as after (+ 6%; NS) PTCA. Nitroglycerin produced dilation of the normal vessel segment to a similar extent pre-(+27%; P < 0-001) and post-(+31%; P < 0-001) PTCA. In contrast, stenotic vessel segments showed coronary vasoconstriction during exercise before PTCA (-28%; P < 0-01); after PTCA, exercise-induced vasoconstriction of the diseased segment was minimal (-4%; NS). Nitroglycerin was associated with vasodi

Sirolimus-Eluting Stents Associated With Paradoxic Coronary Vasoconstriction

“…This paradoxic response of the stenotic arteries during exercise has been attributed to the following four mechanisms (12): 1) reduced nitric oxide bioavailability (endothelial dysfunction); 2) enhanced vasoconstrictor response due to enhanced sympathetic stimulation during exercise; 3) enhanced platelet aggregation due to turbulent blood flow; and 4) flow-induced collapse (Venturi effect). Percutaneous transluminal coronary angioplasty normalizes or improves coronary vasomotion (20). Recently, stent implantation has been shown to abolish paradoxic vasoconstriction of coronary stenoses and to render a previously vasoresponsive vessel into a rigid tube (12).…”

Local vascular dysfunction after coronary paclitaxel-eluting stent implantation

“…In contrast to isometric exercise, dobutamine does not induce paradoxic vasoconstriction of atherosclerotic coronary arteries [24]. Successful balloon angioplasty reverses the constrictive response of stenotic coronary arteries during exercise [25]. The mechanism by which balloon angioplasty improves or restores coronary vasomotion is attributed mainly to an increase in endothelial surface with enhanced nitric-oxide release during exercise.…”

Sport bei Migräne

“…Andererseits mag der klinische Erfolg und zahlreiche wissenschaftliche Belege für kör-perlicher Anstrengung bei einer Reihe internistischer [21,56,64,85] und orthopä-discher [11,43,53,93] und nicht zuletzt neurologischer [70] Erkrankungen auch die therapeutische Einschätzung bei der Migräne beflügelt haben.…”