Coronary vasomotion during dynamic exercise: Influence of intravenous and intracoronary nicardipine

Kaufmann, Philipp A.; Vassalli, Giuseppe; Utzinger, Urs; Hess, Otto M.

doi:10.1016/0735-1097(95)00247-2

Cited by 25 publications

(10 citation statements)

References 37 publications

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“…[25][26][27] In addition, physical capacity at high altitudes of 5000 m has been found to match 70% of the capacity at sea level. 32 Second, data were acquired in the immediate postexercise period, when the cardiac power output is considerably decreased and when flow is also expected to fall rapidly.…”

Section: Discussionmentioning

confidence: 93%

Influence of Altitude Exposure on Coronary Flow Reserve

et al. 2003

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Background-Although no data exist on the effect of altitude exposure on coronary flow reserve (CFR), patients with coronary artery disease (CAD) are advised not to exceed moderate altitudes of Ϸ2500 m above sea level. We studied the influence of altitude on myocardial blood flow (MBF) in controls and CAD patients. Methods and Results-In 10 healthy controls and 8 patients with CAD, MBF was measured by positron emission tomography and 15 O-labeled water at rest, during adenosine stress, and after supine bicycle exercise. This protocol was repeated during inhalation of a hypoxic gas mixture corresponding to an altitude of 4500 m (controls) and 2500 m (CAD). Workload was targeted to comparable heart rate-blood pressure products at normoxia and hypoxia. Resting MBF increased significantly in controls at 4500 m (ϩ24%, PϽ0.01) and in CAD patients at 2500 m (ϩ24%, PϽ0.05). Altitude had no influence on adenosine-induced hyperemia and CFR. Exercise-induced hyperemia increased significantly in controls (ϩ38%, PϽ0.01) at 4500 m (despite a reduction in workload, Ϫ28%, PϽ0.0001) but not in CAD patients at 2500 m (moderate decrease in workload, Ϫ11%, PϽ0.05). Exercise-induced reserve was preserved in controls (ϩ10%, PϭNS) but decreased in CAD patients (Ϫ18%, PϽ0.005). Conclusions-At 2500 m altitude, there is a significant decrease in exercise-induced reserve in CAD patients, indicating that compensatory mechanisms might be exhausted even at moderate altitudes, whereas healthy controls have preserved reserve up to 4500 m. Thus, patients with CAD and impaired CFR should be cautious when performing physical exercise even at moderate altitude.

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Section: Discussionmentioning

confidence: 93%

Influence of Altitude Exposure on Coronary Flow Reserve

et al. 2003

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“…*p Ͻ 0.05 vs. baseline. position (35,36). In addition, physical capacity at high altitudes of 4,500 m has been found to match 70% of the capacity at sea level (37).…”

Section: Discussionmentioning

confidence: 93%

Caffeine Decreases Exercise-Induced Myocardial Flow Reserve

Namdar¹,

Koepfli²,

Grathwohl³

et al. 2006

Journal of the American College of Cardiology

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“…Therefore, MCSF, by increased coronary tone, 38,39 impaired vasodilatation, 19 and formation of microthrombi 40,41 may reduce coronary flow and thus initiate, facilitate, or prolong ischemic episodes. 42,43 Alternatively, ischemic episodes per se may induce an increase in circulating MCSF, as has been demonstrated for IL-6. 44…”

Section: Cytokines and Myocardial Ischemiamentioning

confidence: 99%

Increased Proinflammatory Cytokines in Patients With Chronic Stable Angina and Their Reduction By Aspirin

et al. 1999

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Background —Proinflammatory cytokines released by injured endothelium facilitate interaction of endothelial cells with circulating leukocytes and thus may contribute to development and progression of atherosclerosis. We investigated whether cytokines and C-reactive protein (CRP) are indicative of myocardial ischemia or of diseased vessels and whether they are influenced by aspirin treatment in patients with chronic stable angina. Methods and Results —Plasma macrophage colony stimulating factor (MCSF), IL-1b, IL-6, and CRP were measured in 60 stable patients after 48-hour Holter monitoring and in 24 matched controls. All patients had angiographic documentation of disease and positive exercise ECGs. Patients with ischemia on Holter monitoring (n=40) received aspirin or placebo in a 6-week, randomized, double blind, crossover trial. Blood sampling was repeated at the end of each treatment phase (3 weeks). Compared to controls, patients had more than twice median MCSF (800 versus 372 pg/mL), IL-6 (3.9 versus 1.7 pg/mL), and CRP (1.25 versus 0.23 mg/L) levels ( P <0.01 for all comparisons). MCSF was related to ischemia on Holter monitoring ( P <0.01), to low ischemic threshold during exercise ( P <0.01), and together with IL-1b to number of diseased vessels ( P <0.05). MCSF, IL-6, and CRP were all reduced after 6 weeks of aspirin treatment ( P <0.05). Conclusions —These findings suggest that cytokines are associated with both ischemia and anatomic extent of disease in patients with stable angina. Reduced cytokine and CRP levels by aspirin may explain part of aspirin’s therapeutic action.

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Coronary vasomotion during dynamic exercise: Influence of intravenous and intracoronary nicardipine

Cited by 25 publications

References 37 publications

Influence of Altitude Exposure on Coronary Flow Reserve

Influence of Altitude Exposure on Coronary Flow Reserve

Caffeine Decreases Exercise-Induced Myocardial Flow Reserve

Increased Proinflammatory Cytokines in Patients With Chronic Stable Angina and Their Reduction By Aspirin

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