Advancing age is associated with diminished vascular remodeling and impaired vasodilation in resistance coronary arteries

Ishida, Susumu; Hamasaki, Shuichi; Kamekou, Masahiro; Yoshitama, Takashi; Nakano, Fumio; Yoshikawa, Akiko; Kataoka, Tetsuro; Saihara, Keishi; Minagoe, Shinichi

doi:10.1097/00019501-200309000-00005

Cited by 24 publications

(22 citation statements)

References 25 publications

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“…variation in hyperemic coronary resistance exists, as measured by positron emission tomography (4). Furthermore, age has been identified as a factor that may affect microvascular resistance (4,14). An elevated HMR, as assessed with a dual-sensor guidewire immediately after PCI, has been associated with microvascular dysfunction in patients with STsegment elevation myocardial infarction, and predictive values have been established for extent of transmural infarction and recovery of left ventricular function (2,15,39).…”

Section: Discussionmentioning

confidence: 99%

Minimal effect of collateral flow on coronary microvascular resistance in the presence of intermediate and noncritical coronary stenoses

Verhoeff

Hoef

Spaan

et al. 2012

American Journal of Physiology-Heart and Circulatory Physiology

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-Depending on stenosis severity, collateral flow can be a confounding factor in the determination of coronary hyperemic microvascular resistance (HMR). Under certain assumptions, the calculation of HMR can be corrected for collateral flow by incorporating the wedge pressure (P w) in the calculation. However, although P w Ͼ 25 mmHg is indicative of collateral flow, Pw does in part also reflect myocardial wall stress neglected in the assumptions. Therefore, the aim of this study was to establish whether adjusting HMR by P w is pertinent for a diagnostically relevant range of stenosis severities as expressed by fractional flow reserve (FFR). Accordingly, intracoronary pressure and Doppler flow velocity were measured a total of 95 times in 29 patients distal to a coronary stenosis before and after stepwise percutaneous coronary intervention. HMR was calculated without (HMR) and with Pw-based adjustment for collateral flow (HMRC). FFR ranged from 0.3 to 1. HMR varied between 1 and 5 and HMRC between 0.5 and 4.2 mmHg·cm Ϫ1 ·s. HMR was about 37% higher than HMRC for stenoses with FFR Ͻ 0.6, but for FFR Ͼ 0.8, the relative difference was reduced to 4.4 Ϯ 3.4%. In the diagnostically relevant range of FFR between 0.6 and 0.8, this difference was 16.5 Ϯ 10.4%. In conclusion, P w-based adjustment likely overestimates the effect of potential collateral flow and is not needed for the assessment of coronary HMR in the presence of a flow-limiting stenosis characterized by FFR between 0.6 and 0.8 or for nonsignificant lesions. wedge pressure; fractional flow reserve; coronary circulation CORONARY MICROVASCULAR DYSFUNCTION is increasingly being recognized as a major contributor to myocardial ischemia (3) and is likely associated with an altered coronary hyperemic microvascular resistance (HMR). Hence, a reliable assessment of microvascular resistance is needed that accurately reflects the status of the microcirculation and supports further development of diagnostic tools for microvascular disease.Resistance of a vascular compartment is defined as the ratio between the pressure drop over it and flow through it. Application of the resistance concept to the coronary circulation is challenging in the clinical setting, since volume flow cannot practically be measured directly and coronary back pressure is governed by multiple factors including microvascular conductance and extravascular compressive forces (16,17,32,37). At present, two guidewire-based systems are capable of the combined measurement of pressure and a surrogate of flow through a coronary stenosis. In the first system, flow velocity is measured by a Doppler crystal next to a pressure sensor (31, 35). The second system exploits the temperature sensitivity of the pressure sensor to determine the mean transit time of a temperature change induced by a bolus of saline (10). The corresponding indexes of HMR are respectively defined as the mean distal pressure (P d ) divided by mean distal flow velocity (35) The entrance of the microcirculation is not uniquely defined. Colla...

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Section: Discussionmentioning

confidence: 99%

Minimal effect of collateral flow on coronary microvascular resistance in the presence of intermediate and noncritical coronary stenoses

Verhoeff

Hoef

Spaan

et al. 2012

American Journal of Physiology-Heart and Circulatory Physiology

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“…Aging alters both the endothelium and the VSMC [34], and endothelium-independent response can be altered in presence of hyperinsulinemia in patients with metabolic syndrome [64] or by acute hyperhomocysteinemia in diabetic patients [12]. On the other hand, EX has been shown to increase the relaxant response to NO donors in humans and rabbits [15,33], demonstrating that it can reverse and/or counteract the dysfunctional VSMC relaxant capacities.…”

Section: Endothelium-independent Functionsmentioning

confidence: 99%

Postnatal exposure to voluntary exercise but not the antioxidant catechin protects the vasculature after a switch to an atherogenic environment in middle-age mice

Leblond

Nguyen

Bolduc

et al. 2013

Pflugers Arch - Eur J Physiol

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We aimed to evaluate the lasting functional imprinting of exercise (EX) and catechin (CAT) on the vascular function of middle-age mice switched to a proatherogenic environment. C57BL/6J mice (n=10-15 in each group) fed a regular diet (RD) were exposed from the age of 1 to 9 months either to EX (voluntary running; 2.7± 0.2 km/day), to the polyphenol CAT (30 mg/kg/day in drinking water), or to physical inactivity (PI). At 9 months of age, EX and CAT were stopped and mice either remained on the RD or were fed a Western diet (WD) for an additional 3 months. At 12 months of age, mice from all groups fed a WD had similar body mass, systolic blood pressure, and plasma total cholesterol, glucose, insulin, and isoprostane. Compared to the RD, the WD induced an indomethacin-sensitive aortic endothelium-dependent and independent dysfunction in PI mice (p<0.05) that was prevented by both EX and CAT; this benefit was associated with a higher (p< 0.05) non-nitric oxide/non-prostacyclin endothelium-dependent relaxation. While EX, but not PI or CAT, prevented vascular dysfunction induced by the WD in cerebral arteries, it had no effect in femoral arteries. The profiles of activity of antioxidant enzymes and of proinflammatory gene expression in the aorta suggest a better adaptation of EX>CAT>PI mice to stress. In conclusion, our data suggest that a postnatal exposure to EX, but not to CAT, imprints an adaptive defense capacity in the vasculature against a deleterious change in lifestyle.Correspondence to: Eric Thorin.eric.thorin@umontreal.ca. Electronic supplementary material The online version of this article

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“…Coronary flow reserve to papaverine was calculated as the ratio of maximal CBF induced by papaverine to basal CBF, which was equivalent to the endothelium-independent function of the resistance coronary artery. Endothelium-dependent function was calculated as the percent increase in CBF in response to ACh 15,20,21) .…”

Section: Assessment Of Coronary Blood Flowmentioning

confidence: 99%

Effect of Uric Acid on Coronary Microvascular Endothelial Function in Women: Association with eGFR and ADMA

Kuwahata

Hamasaki

Ishida

et al. 2010

JAT

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Advancing age is associated with diminished vascular remodeling and impaired vasodilation in resistance coronary arteries

Abstract: This study suggests that endothelium-dependent and -independent vasodilation of the resistance coronary artery are impaired with advancing age, which may be in association with attenuated coronary vascular remodeling with aging.

Cited by 24 publications

References 25 publications

Minimal effect of collateral flow on coronary microvascular resistance in the presence of intermediate and noncritical coronary stenoses

Minimal effect of collateral flow on coronary microvascular resistance in the presence of intermediate and noncritical coronary stenoses

Postnatal exposure to voluntary exercise but not the antioxidant catechin protects the vasculature after a switch to an atherogenic environment in middle-age mice

Effect of Uric Acid on Coronary Microvascular Endothelial Function in Women: Association with eGFR and ADMA

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