Effects of distension of urinary bladder on coronary conduit and resistance vessels in hyperlipidemic patients

Abstract

SummaryBackground: Distension of the urinary bladder reflexly causes a change of coronary vasomotor response. The effect of such distension on the coronary circulation in hyperlipidemic patients, a condition with impaired endothelial function, remains unknown.Hypothesis: We tested the hypothesis whether urinary bladder distension caused an exaggerated vasomotor response of epicardial and resistance vasoconstriction in hyperlipidemic patients.Methods: Thirty patients with early atherosclerosis (< 50% diameter stenosis) were divided into three groups: Group 1 (n = 10): hyperlipidemia without doxazosin administration; Group 2 (n = 10): hyperlipidemia with pretreatment of ␣1-adrenergic receptor blocker (oral doxazosin 2 mg); and Group 3 (n = 10): normolipidemia. A prospective analysis of the results of quantitative angiograms, intracoronary Doppler flow, and lactate concentrations from aortic root and coronary sinus was performed during distension of urinary bladder.Results: Bladder distension significantly decreased coronary diameter at the stenotic segments (p = 0.004), coronary blood flow (p = 0.05), and increased coronary resistance (p = 0.006) compared with baseline values, in Group 1 patients. In

Septic Shock Immediately following Percutaneous Suprapubic Catheterization

“…Acute distention of the bladder may also contribute to hematuria, such as in our case, from the overly stretched vesical mucosa [7]. Bladder distention has also been shown to significantly decrease coronary artery diameter at stenotic segments, leading to decreased coronary blood flow and increased coronary resistance [9]. This effect may have been compounded in our patient who had severe disease in the first obtuse marginal artery, contributing to the postoperative myocardial ischemia and subsequent rise in troponin.…”