Effect of stenosis on exercise-induced dilation of large coronary arteries

Jeffrey S. Schwartz; Kenneth W. Baran; Robert J. Bache

doi:10.1016/S0002-8703(05)80273-X

Effect of stenosis on exercise-induced dilation of large coronary arteries

Jeffrey S. Schwartz, Kenneth W. Baran, Robert J. Bache

Medicine - Cardiology Division

Research output: Contribution to journal › Article › peer-review

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Abstract

The effects of a flow-limiting stenosis on external circumflex coronary arterial diameter during treadmill exercise were studied in 10 instrumented dogs. Coronary arterial diameter was measured by sonomicrometry proximal to the stenosis-producing hydraulic occluder so that the effects of a post-stenotic pressure drop were excluded. With no stenosis, heart rate increased (116±7 to 183±10 beats/min, p<0.001), aortic pressure increased (97±3 to 105±5 mm Hg. p<0.005), circumflex coronary blood flow increased (48±8 to 72±8 ml/min, p<0.001), and circumflex coronary diameter increased (3.82±0.29 to 3.93±0.27 mm, p<0.01). In the presence of a flow-limiting stenosis, heart rate increased (120±6 to 176±9 beats/min, p<0.001), aortic pressure did not change significantly (95±4 to 92±4 mm Hg), circumflex coronary blood flow increased slightly (39±8 to 46±9 ml/min, p<0.005), and circumflex coronary arterial diameter did not change significantly (3.78±0.29 to 3.80±0.28 mm). The stenosis prevented the increase in aortic pressure, blunted the increase in circumflex coronary blood flow (24±4 versus 7±2 ml/min, p<0.005), and prevented the increase in circumflex coronary arterial diameter. Therefore normal coronary arteries dilated during exercise and a flow-limiting stenosis prevented exercise-induced coronary dilation proximal to the stenosis, possibly due to both the failure of aortic pressure to increase and less flow-induced endothelium-dependent dilation.

Original language	English (US)
Pages (from-to)	520-534
Number of pages	15
Journal	American Heart Journal
Volume	119
Issue number	3 PART 1
DOIs	https://doi.org/10.1016/S0002-8703(05)80273-X
State	Published - Mar 1990

Bibliographical note

Funding Information:
From the Department of Medicine, Cardiovascular Division, University of Minnesota Medical School. This work was supported by United States Public Health Service grants HL~31510 and HL-20598 from the National Heart, Lung, and Blood Institute of the National Institutes of Health, Bethesda, Md. Received for publication May 8, 1989; accepted Oct. 18, 1989. Reprint requests: Jeffrey S. Schwartz, MD, Dept. of Medicine. State University of New York at Buffalo, The Buffalo General Hospital, 100 High St., Buffalo, NY 14203. 4/1/18015

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title = "Effect of stenosis on exercise-induced dilation of large coronary arteries",

abstract = "The effects of a flow-limiting stenosis on external circumflex coronary arterial diameter during treadmill exercise were studied in 10 instrumented dogs. Coronary arterial diameter was measured by sonomicrometry proximal to the stenosis-producing hydraulic occluder so that the effects of a post-stenotic pressure drop were excluded. With no stenosis, heart rate increased (116±7 to 183±10 beats/min, p<0.001), aortic pressure increased (97±3 to 105±5 mm Hg. p<0.005), circumflex coronary blood flow increased (48±8 to 72±8 ml/min, p<0.001), and circumflex coronary diameter increased (3.82±0.29 to 3.93±0.27 mm, p<0.01). In the presence of a flow-limiting stenosis, heart rate increased (120±6 to 176±9 beats/min, p<0.001), aortic pressure did not change significantly (95±4 to 92±4 mm Hg), circumflex coronary blood flow increased slightly (39±8 to 46±9 ml/min, p<0.005), and circumflex coronary arterial diameter did not change significantly (3.78±0.29 to 3.80±0.28 mm). The stenosis prevented the increase in aortic pressure, blunted the increase in circumflex coronary blood flow (24±4 versus 7±2 ml/min, p<0.005), and prevented the increase in circumflex coronary arterial diameter. Therefore normal coronary arteries dilated during exercise and a flow-limiting stenosis prevented exercise-induced coronary dilation proximal to the stenosis, possibly due to both the failure of aortic pressure to increase and less flow-induced endothelium-dependent dilation.",

author = "Schwartz, {Jeffrey S.} and Baran, {Kenneth W.} and Bache, {Robert J.}",

note = "Funding Information: From the Department of Medicine, Cardiovascular Division, University of Minnesota Medical School. This work was supported by United States Public Health Service grants HL~31510 and HL-20598 from the National Heart, Lung, and Blood Institute of the National Institutes of Health, Bethesda, Md. Received for publication May 8, 1989; accepted Oct. 18, 1989. Reprint requests: Jeffrey S. Schwartz, MD, Dept. of Medicine. State University of New York at Buffalo, The Buffalo General Hospital, 100 High St., Buffalo, NY 14203. 4/1/18015",

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Effect of stenosis on exercise-induced dilation of large coronary arteries

Abstract

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