Coronary microcirculation into different models of left ventricular hypertrophy—hypertensive and athlete's heart: a contrast echocardiographic study

Bello, Vitantonio Di; Giorgi, Davide; Pedrinelli, Roberto; Talini, Enrica; Palagi, Caterina; Nardi, Carmela; Dell’Omo, Giulia; Donne, Maria Grazia Delle; Paterni, Marco; Mariani, Mario

doi:10.1038/sj.jhh.1001547

Cited by 9 publications

(4 citation statements)

References 35 publications

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“…In this study we found that the elevated cardiac microvascular flow in anaemic fetuses was achieved by faster average microvascular blood flux rate, but that MBV fraction at rest was not altered by chronic fetal anaemia. This finding is unexpected as MBV typically increases when growth or remodelling increases coronary flow in adults (Di Bello et al 2003;Indermuhle et al 2006;Ikonomidis et al 2010;Santos et al 2010;Wang et al 2012). Fetal capillary widening in concert with decreased haematocrit can explain the increased coronary microvascular flow observed by MCE.…”

Section: Discussionmentioning

confidence: 94%

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Functional adaptations of the coronary microcirculation to anaemia in fetal sheep

Jonker

Davis

Soman

et al. 2016

The Journal of Physiology

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Fetal anaemia causes cardiac adaptations that have immediate and life-long repercussions on heart function and health. It is known that resting and maximal coronary conductance both increase during chronic fetal anaemia, but the coronary microvascular changes responsible for the adaptive response are unknown. Until recently, technical limitations have prevented quantifying functional capillary-level adaptations in the in vivo fetal heart. Our objective was to characterise functional microvascular adaptations in chronically anaemic fetal sheep. Chronically instrumented fetuses were randomized to a control group (n = 11) or were made anaemic by isovolumetric haemorrhage (n = 12) for 1 week prior to myocardial contrast echocardiography at 85% of gestation. Anaemia augmented cardiac mass by 23% without changing body weight. In anaemic fetuses, microvascular blood flow per volume of myocardium was twice that of control fetuses at rest, during vasodilatory hyperaemia, and during hyperaemia plus increased aortic pressure. The elevated blood flow was attributable almost entirely to an increase in microvascular blood flux rate whereas microvascular blood volumes were not different between groups at baseline, during hyperaemia, or with hyperaemia plus increased aortic pressure. Increased coronary microvascular flux rate in response to chronic fetal anaemia is consistent with expected reductions in capillary resistance from capillary diameter widening detected in earlier histological studies.

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Section: Discussionmentioning

confidence: 94%

“…This finding is unexpected as MBV typically increases when growth or remodelling increases coronary flow in adults (Di Bello et al . ; Indermuhle et al . ; Ikonomidis et al .…”

Section: Discussionmentioning

confidence: 99%

Functional adaptations of the coronary microcirculation to anaemia in fetal sheep

Jonker

Davis

Soman

et al. 2016

The Journal of Physiology

View full text Add to dashboard Cite

show abstract

“…Patients were 77 years old (median) (IQR 73-80), including 36.7% of patients between the ages of 75 and 80 years and 28.5% of patients aged 80 years and older. They had diabetes for 16 years (10)(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25). Their BMI was 29 kg/m 2 (26-33), the systolic blood pressure was 140 mmHg (128-150), and the diastolic blood pressure was 73 mmHg (67-80); 90% of the patients were treated with cardiovascular drugs, including diuretics 53%, sartans 40%, ACE inhibitors 39%, b-blockers 38%, calcium channel blockers 37%, nitrates 7%, anticoagulants 12%, and platelet aggregation inhibitors 56%.…”

Section: Resultsmentioning

confidence: 99%

“…This could suggest that heart failure is not only an index of macroangiopathy related to diabetes. Many other mechanisms have been discussed, including microangiopathic, metabolic, hemodynamic, specific diabetic cardiomyopathy, and thrombotic risks, and the influence of autonomic neuropathy on heart failure (16)(17)(18)(19)(20). It could therefore be the explanation why heart failure in our study showed the strongest association with death compared with other complications, and even when compared with a composite index of four cardiovascular complications.…”

Section: Discussionmentioning

confidence: 99%