Reduced coronary flow reserve in patients with congestive heart failure assessed by transthoracic Doppler echocardiography

Neishi, Yoji; Akasaka, Takashi; Tsukiji, Miwako; Kume, Teruyoshi; Wada, Nozomi; Watanabe, Nozomi; Kawamoto, Takahiro; Kaji, Shuichiro; Yoshida, Kiyoshi

doi:10.1016/j.echo.2004.08.007

Cited by 30 publications

(18 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Coronary flow reserve (CFR) is defined as the ratio of maximal-hyperemic/baseline-resting flow or velocity and is often used as an index of the functional severity of coronary stenoses seen angiographically (Cole and Hartley, 1977;White et al, 1984). Coronary flow reserve is also reduced in the presence of valvular and other forms of heart and vascular diseases which increase loading conditions and produce cardiac hypertrophy (Fallen et al, 1967;Marcus et al, 1982;Marcus, 1983;Santagata et al, 2005;Neishi et al, 2005;Parrish et al, 1985). The mechanism for this reduction is thought to be caused by increases in resting baseline coronary flow due to increased cardiac work (Marcus et al, 1982;Eberli et al, 1989;Parrish et al, 1985;Bache et al, 1987).…”

Section: Introductionmentioning

confidence: 99%

Doppler Estimation of Reduced Coronary Flow Reserve in Mice with Pressure Overload Cardiac Hypertrophy

Hartley

Reddy

Madala

et al. 2008

Ultrasound in Medicine & Biology

View full text Add to dashboard Cite

Aortic banding produces pressure overload cardiac hypertrophy in mice leading to decompensated heart failure in 4-8 wks, but the effects on coronary blood flow velocity and reserve are unknown. To determine whether coronary flow reserve (CFR) was reduced, we used noninvasive 20 MHz Doppler ultrasound to measure left main coronary flow velocity at baseline (B) and at hyperemia (H) induced by low (1%) and high (2.5%) concentrations of isoflurane gas anesthesia. Ten mice were studied before (Pre) and at 1d, 7d, 14d, and 21d after constricting the aortic arch to 0.4 mm diameter distal to the innominate artery. We also measured cardiac inflow and outflow velocities at the mitral and aortic valves and velocity at the jet distal to the aortic constriction. The pressure drop as estimated by 4V 2 at the jet was 51 ± 5.1 (mean ± SE) mmHg at 1d increasing progressively to 74 ± 5.2 mmHg at 21d. Aortic and mitral blood velocities were not significantly different after banding (p = NS), but CFR, as estimated by H/B, dropped progressively from 3.2 ± 0.3 before banding to 2.2 ± 0.4, 1.7 ± 0.3, 1.4 ± 0.2, and 1.1 ± 0.1 at 1d, 7d, 14d, and 21d respectively (all P < 0.01 vs Pre). There was also a significant and progressive increase the systolic/diastolic velocity ratio (0.17 Pre to 0.92 at 21d, all P < 0.01 vs Pre) suggesting a redistribution of perfusion from subendocardium to subepicardium. We show for the first time that CFR, as estimated by the hyperemic response to isoflurane and Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access

show abstract

Section: Introductionmentioning

confidence: 99%

Doppler Estimation of Reduced Coronary Flow Reserve in Mice with Pressure Overload Cardiac Hypertrophy

Hartley

Reddy

Madala

et al. 2008

Ultrasound in Medicine & Biology

View full text Add to dashboard Cite

show abstract

“…During the last decade there have been several reports on the use of noninvasive Doppler ultrasound to estimate coronary flow reserve in man using adenosine (Neishi et al, 2005), dipyridamole Santagata et al, 2005;Saraste et al, 2001), or dobutamine to increase coronary flow. However, because it is difficult to locate and identify specific coronary lesions, these methods have not achieved wide acceptance and are not routinely used in assessing the relationship between anatomy and functional significance in patients with coronary artery disease (Rigo, 2005;Voci et al, 2004).…”

Section: Introductionmentioning

confidence: 99%

Effects of Isoflurane on Coronary Blood Flow Velocity in Young, Old and ApoE−/− Mice Measured by Doppler Ultrasound

Hartley

Reddy

Madala

et al. 2007

Ultrasound in Medicine & Biology

View full text Add to dashboard Cite

The commonly used anesthetic agent, isoflurane (ISO), is a potent coronary vasodilator which could potentially be used in the assessment of coronary reserve, but its effects on coronary blood flow in mice are unknown. Coronary reserve is reduced by age, coronary artery disease, and other cardiac pathologies in man, and some of these conditions can now be modeled in mice. Accordingly, we used Doppler ultrasound to measure coronary flow velocity in mice anesthetized at low (1%) and at high (2.5%) levels of ISO to generate baseline (B) and elevated hyperemic (H) and Y and between A and O were significant (P < 0.01), while the differences in hyperemic velocities were not (P > 0.05). H/B was higher in old mice due to decreased baseline flow rather than increased hyperemic flow velocity. In contrast ApoE −/− mice have increased baseline and hyperemic velocities perhaps due to coronary lesions. The differences in baseline velocities between young and old mice could be due to age-related changes in basal metabolism or to differential sensitivity to isoflurane. We conclude that Doppler ultrasound combined with coronary vasodilation via isoflurane could provide a convenient and noninvasive method to estimate coronary reserve in mice, but also that care must be taken when assessing coronary flow in mice under isoflurane anesthesia because of its potent coronary vasodilator properties.

show abstract

“…Elevation of the basal flow can occur with hypertension, tachycardia, anemia, thyrotoxicosis, or valvular disease, or after caffeine intake (coffee, tea, cola, etc.). The conditions which can decrease the maximum hyperemic flow include not only epicardial coronary stenosis but also microvascular disease with impaired structure, function, rheology, and lower density of capillaries, polycythemia and elevated left ventricle end-diastolic pressure (Baumgart et al, 1998;Hirata et al, 2001;Neishi et al, 2005;de Grigorio et al, 2005;Sherrid et al, 2006;Kaul & Jayaweera, 2008).…”

Section: Factors Influencing Cfvrmentioning

confidence: 99%

Transthoracic Echocardiography in the Assessment of Coronary Arteries

Boshchenko¹,

Vrublevsky²,

Карпов³

2011

Coronary Angiography - Advances in Noninvasive Imaging Approach for Evaluation of Coronary Artery Disease

View full text Add to dashboard Cite

Reduced coronary flow reserve in patients with congestive heart failure assessed by transthoracic Doppler echocardiography

Cited by 30 publications

References 22 publications

Doppler Estimation of Reduced Coronary Flow Reserve in Mice with Pressure Overload Cardiac Hypertrophy

Doppler Estimation of Reduced Coronary Flow Reserve in Mice with Pressure Overload Cardiac Hypertrophy

Effects of Isoflurane on Coronary Blood Flow Velocity in Young, Old and ApoE−/− Mice Measured by Doppler Ultrasound

Transthoracic Echocardiography in the Assessment of Coronary Arteries

Contact Info

Product

Resources

About