Factors that modify the flow response to intracoronary injections.

Abstract

Coronary sinus flow (CSF) was measured in seven patients with normal coronary arteries (group A) during intracoronary injections of 6 ml arterial blood, 6 ml blood from the coronary sinus, 3 and 6 ml isotonic saline, 3 and 6 ml hypertonic glucose, and 6 ml of a contrast agent (sodium metrizoate). In 10 patients with coronary artery disease (group B), CSF was measured after administration of 6 ml isotonic saline, 6 ml sodium metrizoate, and 6 ml of another contrast medium (iohexol). In group A, arterial blood did not affect CSF, while coronary sinus blood induced a 33% increase. After 6 ml isotonic saline, there was a 35% increase in flow and after hypertonic glucose an increase of 70%. Metrizoate induced a rise in flow of 109%. In group B, the increase in CSF after intracoronary injection of saline, metrizoate, and iohexol was 30%, 83%, and 67%, respectively. Blood from the coronary sinus, in contrast to arterial blood, induced a marked rise in peak flow, suggesting a role for reactive hyperemia secondary to myocardial hypoxia in this response. A similar mechanism might have been operative after injection of isotonic saline, as well as after the hyperosmolar contrast agents. However, additional mechanisms mediated by the high osmotic pressure of these substances, such as induction of the Bezold-Jarisch reflex, which will induce coronary vasodilation, may have played a role. Finally, when hyperosmolar agents are used, the possibility of some direct vasodilating properties of the agents cannot be excluded. Circulation 72, No. 2, 287-291, 1985 Material and methodsPatients. Seventeen patients who had been admitted to the hospital for coronary angiographic examination due to anginalike chest pain were investigated. Seven patients (group A) had angiographically normal coronary arteries. Two were women and five men, and their median age was 57 years (range 39 to 62). Group B consisted of 10 patients, all of whom proved to have significant coronary artery disease with narrowing of at least one vessel of more than 70%. There were two female and eight male patients in this group and their median age 57 years (range 48 to 62). No

Συσχέτιση Της Μικροαλβουμινουρίας Με Τις Ελαστικές Ιδιότητες Της Ανιούσας Θωρακικής Αορτής

“…Πξώηνλ, παζεηηθά κέζσ κεηώζεσο ηεο αξηεξηαθήο πίεζεο θαη δεύηεξνλ ελεξγεηηθά, θαζώο βξέζεθε όηη πξνθαινύλ κεηαηόπηζε ηνπ βξόρνπ πίεζεο-δηακέηξνπ ηεο ανξηήο πξνο ηα θάησ, ζε κηα δηαθνξεηηθή ππνζεηηθή ζηγκνεηδή θακπύιε ειαζηηθόηεηαο. Μηα ηέηνηα ελεξγεηηθή δξάζε ησλ αληαγσληζηώλ αζβεζηίνπ ζα κπνξνύζε λα νθείιεηαη ζηελ άκεζε ραιάξσζε ησλ ιείσλ κπηθώλ ηλώλ ηεο ανξηήο 321 , ή ζηελ βειηίσζε ηεο αγγεηνδηαζηαιηηθήο δξαζηεξηόηεηαο ησλ αγγείσλ αγγείσλ (vasa vasorum) 303 .Σα ληηξώδε είλαη αξθεηά απνηειεζκαηηθά σο πξνο ηελ ειάηησζε ηεο ζπζηνιηθήο πίεζεο ζε αζζελείο κε ακηγή ζπζηνιηθή ππέξηαζε 322 . Οη δηεζηαικέλεο ιόγσ ληηξσδώλ αξηεξίεο κεηαθνξάο, εκθαλίδνπλ εληνλόηεξεο ζθύμεηο κε θάζε θαξδηαθή ζπζηνιή.…”