Physiomics of Coronary Perfusion and Cardiac Pumping

Kajiya, Fumihiko; Kajiya, Masahito; Morimoto, Taro; Iwasaki, Tadaaki; Inai, Yousuke; Hirota, Masanori; Kiyooka, Takahiko; Morizane, Yuki; Miyasaka, Takehiro; Mohri, Satoshi; Shimizu, Juichiro

doi:10.1142/9789812775597_0001

Cited by 2 publications

(1 citation statement)

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“…Vanhoutte et al, 2017;Poole et al, 2021], including skeletal muscle (Muller-Delp et al, 2002) and the diaphragm (Horn et al, 2019). Impaired endothelial function has been demonstrated in pulmonary arteries (Mathew et al, 1995;Christou et al, 2018), coronary arterioles (Kajiya et al, 2007), and large systemic arteries (Wolff et al, 2007;Peled et al, 2008) with PH. However, there is a paucity of data regarding diaphragm vascular function.…”

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confidence: 99%

Pulmonary hypertension alters blood flow distribution and impairs the hyperemic response in the rat diaphragm

Schulze,

Horn,

Weber

et al. 2023

Front. Physiol.

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Pulmonary hypertension (PH) is characterized by pulmonary vascular remodeling, respiratory muscle and cardiac impairments, and exercise intolerance. Specifically, impaired gas exchange increases work of the diaphragm; however, compromised contractile function precludes the diaphragm from meeting the increased metabolic demand of chronic hyperventilation in PH. Given that muscle contractile function is in part, dependent upon adequate blood flow (Q˙), diaphragmatic dysfunction may be predicated by an inability to match oxygen delivery with oxygen demand. We hypothesized that PH rats would demonstrate a decreased hyperemic response to contractions compared to healthy controls.Methods: Sprague-Dawley rats were randomized into healthy (HC, n = 7) or PH (n = 7) groups. PH rats were administered monocrotaline (MCT) while HC rats received vehicle. Disease progression was monitored via echocardiography. Regional and total diaphragm blood flow and vascular conductance at baseline and during 3 min of electrically-stimulated contractions were determined using fluorescent microspheres.Results: PH rats displayed morphometric and echocardiographic criteria for disease (i.e., acceleration time/ejection time, right ventricular hypertrophy). In all rats, total costal diaphragm Q˙ increased during contractions and did not differ between groups. In HC rats, there was a greater increase in medial costal Q˙ compared to PH rats (55% ± 3% vs. 44% ± 4%, p < 0.05), who demonstrated a redistribution of Q˙ to the ventral costal region.Conclusion: These findings support a redistribution of regional diaphragm perfusion and an impaired medial costal hyperemic response in PH, suggesting that PH alters diaphragm vascular function and oxygen delivery, providing a potential mechanism for PH-induced diaphragm contractile dysfunction.

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Section: Figurementioning

confidence: 99%

Pulmonary hypertension alters blood flow distribution and impairs the hyperemic response in the rat diaphragm

Schulze,

Horn,

Weber

et al. 2023

Front. Physiol.

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Medical treatment and long-term outcome of chronic atrial fibrillation in the aged with chest distress: a retrospective analysis versus sinus rhythm

Guo

Zhang²,

Wang³

et al. 2011

CIA

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Although “chest distress” is the most frequent complication in the aged with chronic atrial frbrillation (AF) in clinical practice, there are few data on the association between chronic AF and coronary artery disease (CAD) in the aged in terms of medical treatment and long-term outcome. We assessed coronary artery lesions in such patients and evaluated the efficacy of medical treatment in long-term follow-ups. Of 315 elderly patients (mean age: 77.39 ± 6.33 years) who had undergone coronary angiography for chest distress, 297 exhibited sinus rhythm (SR), whereas 18 patients exhibited chronic AF. Patients with AF were followed for 4.22 ± 2.21 years. Average diastolic blood pressure (DBP) of AF patients was observed to be markedly less than that of patients with SR (57.33 ± 6.87 mmHg vs 71.08 ± 10.54 mmHg, t-test: P < 0.01). Compared with SR patients, severe stenosis of the coronary artery in AF patients was reduced (73.06% vs 44.44%, Chi-square test: P < 0.01). AF patients with chest distress had high CHADS2 score (3.72 ± 1.27), but only 33.3% patients received oral anticoagulants, and such patients had a significantly lower rate of revascularization (21.43% vs 55.63%, Chi-square test: P < 0.01), and higher rate of all-cause death (22.22% vs 4.38%, Chi-square test: P < 0.01) and thromboembolism (16.67% vs 1.68%, Chi-square test: P < 0.01) in the long-term follow-ups compared with SR patients. Chest distress in the aged with AF was related to insufficient coronary blood supply that was primarily due to a reduced DBP rather than to occult CAD. Adequate and safe medical therapy was difficult to achieve in these patients. Such patients typically have a poor prognosis, and optimal therapeutic strategies to treat them are urgently needed.

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Physiomics of Coronary Perfusion and Cardiac Pumping

Cited by 2 publications

References 0 publications

Pulmonary hypertension alters blood flow distribution and impairs the hyperemic response in the rat diaphragm

Pulmonary hypertension alters blood flow distribution and impairs the hyperemic response in the rat diaphragm

Medical treatment and long-term outcome of chronic atrial fibrillation in the aged with chest distress: a retrospective analysis versus sinus rhythm

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