Coronary microvascular endothelial dysfunction in transplanted children

Gagliardi, Maria Giulia; Crea, Filippo; Polletta, B.; Bassano, Carlo; Vigna, Gianluca; Ballerini, Luigi; Ragonese, P

doi:10.1053/euhj.2001.2105

Cited by 17 publications

(20 citation statements)

References 22 publications

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“…The only available studies measuring CFR by IDGW in healthy children (aged 10 to 19 years) have shown mean values of 3.4 to 3.7. 8,9 These CFR values are comparable to our results and indicate that the CFR, or more specifically the vasoreactivity of the myocardial microvasculature, is normal in our patient group.…”

Section: Discussionsupporting

confidence: 78%

“…4 -6 The basal flow velocities in both LAD and RCA in this study are lower than what has been reported in previous studies in children of comparable age and in adults, and this speaks strongly against increased coronary blood flow at rest. 8,10,14 The peak systolic flow velocity was higher in the RCA than in the LAD (22.0 cm/s versus 15.0 cm/s) in our subjects. This agrees well with earlier animal studies, and may be explained by lower systolic pressure and lower intramyocardial resistance against coronary flow in the right ventricle.…”

Section: Discussionmentioning

confidence: 82%

“…8,10,14,15 PET studies have indicated that myocardial blood flow at rest may be increased in subjects operated for TGA with the ASO. 4 -6 The basal flow velocities in both LAD and RCA in this study are lower than what has been reported in previous studies in children of comparable age and in adults, and this speaks strongly against increased coronary blood flow at rest.…”

Section: Discussionmentioning

confidence: 99%

“…A higher dose of a similar drug, halothane, has not been shown to affect coronary flow reserve in children. 8 Measurements of coronary flow velocity and CFR with the IDGW have been thoroughly validated, both in vitro and in vivo. 26,27 The method has been reported to be safe, and there were no coronary complications in our study, neither during selective coronary angiography nor during intracoronary Doppler registration.…”

Section: Methodsmentioning

confidence: 99%

“…That would require intracoronary injection of acetylcholine, and because this drug may cause coronary spasms and other serious side effects, we found the risk of this procedure unacceptable for our study group. 8 …”

Section: Study Limitationsmentioning

confidence: 99%

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Normal Coronary Flow Reserve After Arterial Switch Operation for Transposition of the Great Arteries

et al. 2002

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Background-Recent studies performed with positron emission tomography have suggested that coronary flow reserve (CFR) is moderately to severely reduced after the arterial switch operation (ASO). These findings are of great concern but have not been confirmed by other methods. Methods and Results-Eleven symptom-free children were studied between 4 and 11 (median 6.0) years after the ASO.Flow velocity in the left anterior descending (LAD) and right coronary arteries (RCA) was measured with a 0.014-inch Doppler FloWire (Cardiometrics) before and after intracoronary injection of adenosine (0.5 g/kg) and nitroglycerin (5 g/kg). CFR was defined as the ratio of hyperemic to basal average peak velocity (APV). The median (range) CFR in the LAD was 3.7 (3.0 to 4.8) and 3.4 (2.9 to 4.8) in the RCA. The increase in APV after intracoronary injection of nitroglycerin was 300% (240% to 420%) in the LAD and 260% (190% to 460%)

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Section: Discussionsupporting

confidence: 78%

Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Study Limitationsmentioning

confidence: 99%

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Normal Coronary Flow Reserve After Arterial Switch Operation for Transposition of the Great Arteries

et al. 2002

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Usefulness of left ventricular diastolic function assessed by magnetic resonance imaging over invasive coronary flow reserve measurement for detecting cardiac allograft vasculopathy in heart transplant recipients

Machida

Nunoda

Shitakura

et al. 2012

Int J Cardiovasc Imaging

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Heart transplant recipients undergo annual screening of early-stage cardiac allograft vasculopathy (CAV) by invasive coronary flow reserve (CFR) measurement. We compared the sensitivity for CAV detection between the CFR measurement and noninvasive magnetic resonance (MR) assessment of left ventricular (LV) diastolic function. In 46 asymptomatic recipients (29 men, aged 35.2 ± 16.1 years) 7.9 ± 4.3 years after transplantation, we measured LV peak filling rate (PFR) using cine MR and CFR in the left anterior descending artery by Doppler guidewire; classified recipients of class 0-2 as negative for CAV and class 3-4, positive, according to Stanford classification assessed by IVUS; compared those values between the 2 groups; and calculated receiver operating characteristic curve in the relationship between PFR value and CAV. We classified 20 recipients (43%) positive and 26 (57%) negative for CAV. Although there was no significant difference in CFR value, the PFR value was significantly lower in the positive (3.54 ± 0.84 EDV/s) than in negative group (4.39 ± 0.85 EDV/s, P = 0.002). Area under the curve was 0.78, and the sensitivity was 78% and specificity, 61%, when PFR cut-off value was 4.20. MR PFR measurement provides noninvasive prediction of CAV, preceding impaired CFR in asymptomatic recipients.

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Coronary microvascular dysfunction in childhood: An emerging pathological entity and its clinical implications

Tsuda,

Patel

2024

American Heart Journal Plus: Cardiology Research and Practice

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Coronary microvascular endothelial dysfunction in transplanted children

Abstract: Endothelial dysfunction in paediatric transplanted patients becomes more evident in patients with longer follow-up. This finding could prove useful in the prevention of accelerated arteriosclerosis.

Cited by 17 publications

References 22 publications

Normal Coronary Flow Reserve After Arterial Switch Operation for Transposition of the Great Arteries

Normal Coronary Flow Reserve After Arterial Switch Operation for Transposition of the Great Arteries

Usefulness of left ventricular diastolic function assessed by magnetic resonance imaging over invasive coronary flow reserve measurement for detecting cardiac allograft vasculopathy in heart transplant recipients

Coronary microvascular dysfunction in childhood: An emerging pathological entity and its clinical implications

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