Aims: Myocardial blood flow(MBF) is the gold standard to assess myocardial blood supply and, as recently shown, can be obtained by myocardial contrast echocardiography(MCE). The aims of this human study are(i) to test...Aims: Myocardial blood flow(MBF) is the gold standard to assess myocardial blood supply and, as recently shown, can be obtained by myocardial contrast echocardiography(MCE). The aims of this human study are(i) to test whether measurements of collateral-derived MBF by MCE are feasible during elective angioplasty and(ii) to validate the concept of pressure-derived collateral-flow assessment. Methods and results: Thirty patients with stable coronary artery disease underwent MCE of the collateral-receiving territory during and after angioplasty of 37 stenoses. MCE perfusion analysis was successful in 32 cases. MBF during and after angioplasty varied between 0.060- 0.876 mL min- 1 g- 1(0.304± 0.196 mL min- 1 g- 1) and 0.676- 1.773 mL min- 1 g- 1(1.207± 0.327 mL min- 1 g- 1), respectively. Collateral-perfusion index(CPI) is defined as the rate of MBF during and after angioplasty varied between 0.05 and 0.67(0.26± 0.15). During angioplasty, simultaneous measurements of mean aortic pressure, coronary wedge pressure, and central venous pressure determined the pressure-derived collateral-flow index(CFIp), which varied between 0.04 and 0.61(0.23± 0.14). Linear regression analysis demonstrated an excellent agreement between CFIp and CPI(y=0.88x + 0.01; r2=0.92; P< 0.0001). Conclusion: Collateral-derived MBF measurements by MCE during angioplasty are feasible and proved that the pressure-derived CFI exactly reflects collateral relative to normal myocardial perfusion in humans.展开更多
Objective To investigate the effect of diabetes on coronary collateral development. Methods A dog model of diabetes was induced by intravenous injecting alloxan and streptozotocin. Dogs were subjected to brief (2 min)...Objective To investigate the effect of diabetes on coronary collateral development. Methods A dog model of diabetes was induced by intravenous injecting alloxan and streptozotocin. Dogs were subjected to brief (2 min), repetitive coronary artery occlusions (8 times per day for 21days) in the absence (ischemia n=8) or presence of diabetes (diabetes+ischemia n=6). A sham group (n=8) was instrumented identically but received no occlusion. Myocardial blood flow was determined in the myocardium perfused by the left anterior descending coronary artery (LAD) and the left circumflex coronary artery (LCCA). Peak reactive hyperemia response (PRH) was recorded on experimental days 1, 7, 14 and 21. Colla teral blood flow was expressed as the percentage of normal zone blood flow. Results Fasting blood glucose in the diabetes+ischemia group (17.5 mmol·L -1±1.1 mmol·L -1, 18.6 mmol·L -1±1.1 mmol·L -1, 21.6 mmol·L -1±1.5 mmol·L -1 and 21.9 mmol·L -1±1.5 mmol·L -1 on days 1, 7, 14 and 21, respectively) were significantly higher than those in the ischemia group (3.9 mmol·L -1±1.0 mmol·L -1, P<0.01). Coronary collateral blood flow was significantly increased in ischemia dogs (71%±7%) after 21 days but remained unchanged in sham dogs. The collateral blood flow in the diabetes+ischemia group after 21 days was only 17%±6%, which was significantly lower than that in the ischemia group (P<0.01). PRH in the ischemia group was 7.6 Hz·102±2.9 Hz·102 on days 21, which was significantly lower than that on day 1 (16.4 Hz·102±2.9 Hz·102, P<0.05). PRH remained unchanged in the diabetes+ischemia and sham group. PRH in diabetes+ischemia dogs (15.6 Hz·102±2.5 Hz·102) on days 21 was significantly higher than that in ischemia dogs (P<0.05). Conclusions Diatetes inhibits the development of coronary collateral blood flow.展开更多
文摘Aims: Myocardial blood flow(MBF) is the gold standard to assess myocardial blood supply and, as recently shown, can be obtained by myocardial contrast echocardiography(MCE). The aims of this human study are(i) to test whether measurements of collateral-derived MBF by MCE are feasible during elective angioplasty and(ii) to validate the concept of pressure-derived collateral-flow assessment. Methods and results: Thirty patients with stable coronary artery disease underwent MCE of the collateral-receiving territory during and after angioplasty of 37 stenoses. MCE perfusion analysis was successful in 32 cases. MBF during and after angioplasty varied between 0.060- 0.876 mL min- 1 g- 1(0.304± 0.196 mL min- 1 g- 1) and 0.676- 1.773 mL min- 1 g- 1(1.207± 0.327 mL min- 1 g- 1), respectively. Collateral-perfusion index(CPI) is defined as the rate of MBF during and after angioplasty varied between 0.05 and 0.67(0.26± 0.15). During angioplasty, simultaneous measurements of mean aortic pressure, coronary wedge pressure, and central venous pressure determined the pressure-derived collateral-flow index(CFIp), which varied between 0.04 and 0.61(0.23± 0.14). Linear regression analysis demonstrated an excellent agreement between CFIp and CPI(y=0.88x + 0.01; r2=0.92; P< 0.0001). Conclusion: Collateral-derived MBF measurements by MCE during angioplasty are feasible and proved that the pressure-derived CFI exactly reflects collateral relative to normal myocardial perfusion in humans.
文摘Objective To investigate the effect of diabetes on coronary collateral development. Methods A dog model of diabetes was induced by intravenous injecting alloxan and streptozotocin. Dogs were subjected to brief (2 min), repetitive coronary artery occlusions (8 times per day for 21days) in the absence (ischemia n=8) or presence of diabetes (diabetes+ischemia n=6). A sham group (n=8) was instrumented identically but received no occlusion. Myocardial blood flow was determined in the myocardium perfused by the left anterior descending coronary artery (LAD) and the left circumflex coronary artery (LCCA). Peak reactive hyperemia response (PRH) was recorded on experimental days 1, 7, 14 and 21. Colla teral blood flow was expressed as the percentage of normal zone blood flow. Results Fasting blood glucose in the diabetes+ischemia group (17.5 mmol·L -1±1.1 mmol·L -1, 18.6 mmol·L -1±1.1 mmol·L -1, 21.6 mmol·L -1±1.5 mmol·L -1 and 21.9 mmol·L -1±1.5 mmol·L -1 on days 1, 7, 14 and 21, respectively) were significantly higher than those in the ischemia group (3.9 mmol·L -1±1.0 mmol·L -1, P<0.01). Coronary collateral blood flow was significantly increased in ischemia dogs (71%±7%) after 21 days but remained unchanged in sham dogs. The collateral blood flow in the diabetes+ischemia group after 21 days was only 17%±6%, which was significantly lower than that in the ischemia group (P<0.01). PRH in the ischemia group was 7.6 Hz·102±2.9 Hz·102 on days 21, which was significantly lower than that on day 1 (16.4 Hz·102±2.9 Hz·102, P<0.05). PRH remained unchanged in the diabetes+ischemia and sham group. PRH in diabetes+ischemia dogs (15.6 Hz·102±2.5 Hz·102) on days 21 was significantly higher than that in ischemia dogs (P<0.05). Conclusions Diatetes inhibits the development of coronary collateral blood flow.
