Determinants of coronary arterial flow‐mediated dilatation following percutaneous coronary intervention

McGrady, Michele; Thanyasiri, Panuratn; Bailey, Brian P.; Celermajer, David S.; Adams, Mark

doi:10.1002/ccd.21375

Cited by 4 publications

(3 citation statements)

References 53 publications

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“…The peak increase in arterial diameter is calculated (%FMD) and used as an index of systemic endothelial function [2, 3]. Impairment of endothelial function is central to the pathogenesis of atherosclerotic cardiovascular disease [4] and presence of cardiovascular risk factors is associated with attenuated brachial artery FMD [5,6,7] as well as coronary artery FMD [8]. …”

Section: Introductionmentioning

confidence: 99%

Adjusting Flow-Mediated Dilation for Shear Stress Stimulus Allows Demonstration of Endothelial Dysfunction in a Population with Moderate Cardiovascular Risk

et al. 2009

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Background/Aims: Although normalization of brachial artery flow-mediated dilation (FMD) to individual shear stress (FMD:shear stress ratio) has been proposed to improve this measure of endothelial function, the clinical utility of FMD normalization has not yet been demonstrated. We tested (1) whether following conventional 5-min forearm occlusion, the FMD:shear stress ratio would discriminate a population with moderate cardiovascular risk (MR) from a low-risk (LR) population, and (2) whether the dose-response profile relating shear stress to FMD would be different between the 2 populations. Methods: Five different magnitudes of reactive hyperemia-induced shear stress were applied to 20 MR and 20 LR subjects by manipulating forearm cuff occlusion duration. Brachial artery diameters and velocities were measured via high-resolution ultrasound. To quantify the hyperemic stimulus, shear stress area under the curve was individually calculated for the duration of time-to-peak dilation. Results: Following 5-min of forearm occlusion, FMD:shear stress ratio (p = 0.041), but not FMD (p = 0.286), discriminated MR from LR. The slope of the shear stress-FMD regression line was lower in MR compared to the LR (p <0.001). Conclusion: The FMD:shear stress ratio distinguished reduced endothelial function in a population with MR. The dose-response profile of the shear stress-FMD relationship appears to differ between populations of distinct cardiovascular risk.

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Section: Introductionmentioning

confidence: 99%

Adjusting Flow-Mediated Dilation for Shear Stress Stimulus Allows Demonstration of Endothelial Dysfunction in a Population with Moderate Cardiovascular Risk

et al. 2009

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“…The normal diameter of native coronary vessels can be underestimated in post-mortem and conventional invasive angiographic studies [11-14]. These studies usually assess only the mid-portion of the proximal segment of the coronary vessels rather than the ostium (the aorto-coronary junction), and report diameters of 2–5 mm for the RCA and 4–7 mm for the LMA.…”

Section: Discussionmentioning

confidence: 99%

A novel parasternal transthoracic echocardiographic window for detecting coronary ostial dilation after modified Bentall surgery

Hanzek

Kritharides

et al. 2013

Cardiovasc Ultrasound

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BackgroundDuring the modified Bentall surgery (aortic root replacement), a cuff of native aorta is implanted, together with the coronary ostium, into the aortic graft. Multi-detector computed tomography (MDCT) imaging can accurately assess the coronary ostial anastomosis site post-surgery. In this study, we assessed the feasibility of imaging the coronary ostial anastomosis site using transthoracic echocardiography (TTE).MethodsPatients (n = 14, mean age 65 ± 12 years, 79% males) with previous Bentall surgery underwent TTE study, with MDCT (64-slice) as the reference standard. TTE used conventional and novel acoustic windows to interrogate the coronary ostia.ResultsAll coronary ostia (n = 28) were well-visualized with MDCT. The optimum TTE acoustic window for visualizing the coronary ostia was a superiorly positioned parasternal short-axis view with the probe tilted towards the left shoulder, medially angulated for the right coronary artery ostia (RCAos) and laterally angulated for the left main coronary artery (LMAos). In this off-axis position, 10 (71%) LMAos and 13 (93%) RCAos could be visualized. In the conventional parasternal views, only 5 (36%) RCAos and no LMAos could be visualized. TTE underestimated the diameter of the LMAos (10.0 ± 2.4 mm TTE vs. 13.4 ± 2.7 mm MDCT, p = 0.007), but was similar to MDCT for the RCAos (9.8 ± 3.1 mm TTE vs. 11.1 ± 3.2 mm MDCT, p = 0.10).ConclusionsWe report a novel TTE acoustic window to image the coronary ostia of post-Bentall surgery patients. Although TTE underestimates the left coronary ostium size, recognition of the ostial dilation with TTE appears feasible in most patients. Those that cannot be imaged will require alternative imaging modality such as MDCT.

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“…The present study showed that whilst conventional TTE failed to adequately assessed the coronary ostia of these patients, an alternative novel TTE acoustic window was able to visualize most of the coronary ostia, thus providing a potentially suitable alternative noninvasive imaging tool to monitor the coronary ostial dilation long-term. The normal diameter of native coronary vessels can be underestimated in post-mortem and conventional invasive angiographic studies [11][12][13][14]. These studies usually assess only the mid-portion of the proximal segment of the coronary vessels rather than the ostium (the aortocoronary junction), and report diameters of 2-5 mm for the RCA and 4-7 mm for the LMA.…”

Section: Discussionmentioning

confidence: 99%

A Novel Parasternal Transthoracic Echocardiographic Window for Detecting Coronary Ostial Dilation after Modified Bentall Surgery

Hanzek

Yong

et al. 2009

Heart, Lung and Circulation

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Background: During the modified Bentall surgery (aortic root replacement), a cuff of native aorta is implanted, together with the coronary ostium, into the aortic graft. Multi-detector computed tomography (MDCT) imaging can accurately assess the coronary ostial anastomosis site post-surgery. In this study, we assessed the feasibility of imaging the coronary ostial anastomosis site using transthoracic echocardiography (TTE).

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Determinants of coronary arterial flow‐mediated dilatation following percutaneous coronary intervention

Abstract: FMD occurs in human coronary arteries following restoration of flow. The magnitude of FMD appears related to vascular risk factors and their treatment.

Cited by 4 publications

References 53 publications

Adjusting Flow-Mediated Dilation for Shear Stress Stimulus Allows Demonstration of Endothelial Dysfunction in a Population with Moderate Cardiovascular Risk

Adjusting Flow-Mediated Dilation for Shear Stress Stimulus Allows Demonstration of Endothelial Dysfunction in a Population with Moderate Cardiovascular Risk

A novel parasternal transthoracic echocardiographic window for detecting coronary ostial dilation after modified Bentall surgery

A Novel Parasternal Transthoracic Echocardiographic Window for Detecting Coronary Ostial Dilation after Modified Bentall Surgery

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