Assessment of Coronary Flow Parameters by Transesophageal Echocardiography in Patients with Isolated Coronary Artery Ectasia: Effect of Intravenous Nitroglycerin

Abstract

Patients with CAE have higher resting coronary blood flow in comparison with subjects with normal coronaries. Intravenous nitroglycerin administration causes significant reduction of coronary blood flow in ectatic coronary arteries.

Point of controversy: perioperative care of patients undergoing pheochromocytoma removal–time for a reappraisal?

“…Toxic metabolites such as cyanide and thiocyanate are a concern only when the agent is administered in high doses and/or for more than 48-72 h, in patients with abnormal renal and hepatic function, and when the infusion rate is O 2 mg/kg per min (56). -Nitroglycerin is a rapid-acting venodilator (57). Its onset and duration of action are rapid.…”

“…It reduces preload and increases coronary blood flow by dilating collateral vessels and suppressing coronary vasospasm (57). High doses of nitroglycerin produce arteriolar vasodilation (57). Nitroglycerin is a suitable drug in patients with ischemic heart disease (57).…”

Effect of Intravenous Dipyridamole on Coronary Flow Parameters in Patients with Isolated Coronary Artery Ectasia: Assessment by Transesophageal Echocardiography

“…The issue of vasodilator use in patients with CAE has always been a matter of controversy. Nitroglycerin administration demonstrated a significant reduction of coronary blood flow in ectatic coronary arteries, 12 and exaggerated myocardial ischemia induced by right atrial pacing (as evidenced by increased coronary sinus lactate) 2 . Intracoronary papaverine achieved a modest increase of the total coronary blood flow in patients with CAE, with a papaverine‐induced coronary flow reserve of 1.51 (as compared to 2.67 in the control group) 3 .…”

Nitroglycerin-induced Heterogeneous Subendocardial Myocardial Blood Flow Observed by Cardioscopy in Patients With Coronary Artery Disease

“…SMBF has been clinically evaluated by scintigraphic perfusion imaging, [1][2][3] positron emission tomography, 4,5) contrast echocardiography, coronary angiography, and other methods, 6) and an increase in SMBF was demonstrated by some of these methods. 6) Coronary trees are composed of multiple vessels which form a sponge-like architecture.…”

“…6) Coronary trees are composed of multiple vessels which form a sponge-like architecture. Therefore, both arterial and venous blood can drain into the ischemic myocardium.…”