Standardization of coronary vasomotor tone with intracoronary nitroglycerin

Jost, Stefan; Stürm, Matthias; Hausmann, Dirk; Lippolt, Peter; Lichtlen, Paul R.

doi:10.1016/s0002-9149(96)00243-3

Cited by 12 publications

(9 citation statements)

References 10 publications

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“…To allow for quantitative analysis of the angiograms, the following modifications were made. To minimize coronary tone, 200 lg of intracoronary glyceryl trintrate (GTN) was injected into the left main stem and right coronary artery 30 seconds before the first angiogram was acquired (17). After the sequence of angiographic images of the left coronary system had been completed, the image in the first projection was acquired again to assess the short-term reproducibility of the QCA measurements.…”

Section: Quantitative Coronary Angiographymentioning

confidence: 99%

Impaired Left Ventricular Systolic Function Early After Heart Transplantation is Associated with Cardiac Allograft Vasculopathy

Bolad

Robinson

Webb

et al. 2006

American Journal of Transplantation

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Cardiac allograft vasculopathy (CAV) is a major cause of death more than 1 year after heart transplantation. We evaluated the role and possible predictive value of different etiological factors on development of CAV as diagnosed by quantitative coronary angiography (QCA). A total of 121 patients were studied with baseline QCA and 117 had a follow-up study at 1 year to assess the relationship of mean lumen diameter loss (MLDL) in main coronary arteries to immunological and non-immunological factors potentially affecting long-term survival. Out of them, 103 patients were males (85%), 114 (94%) patients were Caucasians and mean age was 48.5 ± 10 years. Univariate analysis showed that MLDL at 1 year was inversely related to echocardiographic fractional shortening (FS) measured within the first week after transplantation (p = 0.0098) and to intracranial hemorrhage as cause of donor death (p = 0.04) and was directly related to male donors (p = 0.0008), domino transplants (p = 0.037) and donor negative cytomegalovirus (CMV) status (p = 0.022). Multivariate analysis showed that initial FS (p = 0.006) and donor intracranial hemorrhage as a cause of death (p = 0.042) were inversely related to MLDL whereas donor male sex (p = 0.003) and prednisolone treatment throughout the first year (p = 0.012) were directly related. Thus, left ventricular systolic dysfunction early after heart transplantation was associated with subsequent development of CAV.

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Section: Quantitative Coronary Angiographymentioning

confidence: 99%

Impaired Left Ventricular Systolic Function Early After Heart Transplantation is Associated with Cardiac Allograft Vasculopathy

Bolad

Robinson

Webb

et al. 2006

American Journal of Transplantation

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“…Our study adds to the current knowledge by reporting for the first time an excellent correlation of plaque volumes determined by 64-slice MDCT and IVUS (without systematic underestimation by MDCT), systematically using nitroglycerin (before MDCT and IVUS) and 40 MHz catheters. Our study is also the first to report the comparison of 64-slice MDCT and QCA, incorporating the careful use of nitroglycerin before both examinations as recommended (10), to eliminate differences in vasomotor tone (11,12). In contrast, some studies have described suboptimal specificity of MDCT compared with QCA (1,2).…”

Section: Discussionmentioning

confidence: 93%

“…Also, nitroglycerin was not systematically administered before MDCT in many previous comparative studies, which sometimes involved its use before invasive angiography only (9). Administration of nitroglycerin has been advocated for better assessment of stenosis severity in such studies (10) because variable vasomotor tone may influence results (11,12), especially when they are based on dichotomous outcomes (typically, stenosis greater than 50%). Therefore, the main objective of the present study was to compare coronary arterial plaque volumes determined by 64-slice MDCT and IVUS.…”

Section: Résultatsmentioning

confidence: 99%

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Evaluation of coronary atheroma by 64-slice multidetector computed tomography: Comparison with intravascular ultrasound and angiography

Ugolini

Pressacco

Lespérance

et al. 2009

Canadian Journal of Cardiology

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“…The doses of NTG and fasudil used in the present study were thought to exert adequate vasodilatory effects. 16,[30][31][32] At 1 min after the administration of NTG and at the end of the infusion of fasudil, coronary angiography was repeated and the grade and morphology of the stenosis was visually re-assessed.…”

Section: Study Protocolmentioning

confidence: 99%

Vasodilatory Effect of Subsequent Administration of Fasudil, a Rho-Kinase Inhibitor, Surpasses That of Nitroglycerin at the Concentric Coronary Stenosis in Patients With Stable Angina Pectoris

Otsuka

Ibuki

Suzuki

et al. 2006

Circ J

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oronary arteries exert a vasomotor action that responds to numerous stimuli such as neurohormonal factors, endothelium-derived substances, and artificially administered vasoactive agents in a sensitive manner. 1,2 Indeed, intact epicardial coronary arteries dilate promptly after the administration of nitrates or other kinds of vasodilators. 3 In contrast, it remains controversial 4-8 as to whether the coronary atherosclerotic site responds to vasodilatory agents; this continues to be an important topic in terms of the treatment of stable angina pectoris (SAP). In clinical situations, Kaski et al 6 and Yamagishi et al 8 reported that the vasodilatory potential at the coronary atherosclerotic site was impaired. In contrast, McPherson et al suggested in their report 7 that the coronary atherosclerotic site had a vasodilating ability. It should be emphasized, however, that these clinical studies only adopted nitrates for the evaluation of coronary vasomotion at the site of atherosclerotic lesions. Therefore, other vasodilators than nitrates should be used to more accurately assess the vasodilatory potential at atherosclerotic lesions.It has recently been reported that the Rho/Rho-kinase mediated pathway (Rho-kinase pathway) is involved in the pathogenesis of various cardiovascular disorders. 9-16 Rhokinase is one of the downstream effectors of small GTPase Rho, and it plays a pivotal role in diverse cellular functions, such as actin cytoskeleton organization, 17,18 cell adhesion and motility, 19 cytokinesis, 20 gene expression, 21 and smooth muscle contraction. 22 In clinical situations, the Rho-kinase pathway contributes to the occurrence of both epicardial 23 and microvascular 24 coronary artery spasm and the augmentation of peripheral vascular resistance in both patients with hypertension 25 and normotensive current smokers. 26 These findings suggest that the Rho-kinase pathway regulates the vasomotion of arteries suffering from pathological conditions. It remains unclear, however, as to whether this pathway is also involved in the regulation of coronary vasomotion at the atherosclerotic site, which is one of the most prevalent diseased states in the arterial wall.We therefore hypothesized that the degree of coronary vasodilation at the atherosclerotic site with pharmacological inhibition of the Rho-kinase pathway was more potent than that with nitrates. In the present study, to confirm this hypothesis, we compared the vasodilatory effect of nitroglycerin (NTG) with the subsequent administration of fasudil, a Rho-kinase inhibitor, at a site of concentric coronary stenosis, which was considered to reflect the whole circumferential atherosclerosis in the arterial wall, 27 in patients with SAP. Background Recent studies have suggested that the Rho/Rho-kinase mediated pathway (Rho-kinase pathway) regulates the vasomotion of arteries in pathological conditions. However, it remains unclear regarding whether this pathway regulates the coronary vasomotion of atherosclerotic lesions. Methods and ResultsThe coronary diamet...

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Standardization of coronary vasomotor tone with intracoronary nitroglycerin

Cited by 12 publications

References 10 publications

Impaired Left Ventricular Systolic Function Early After Heart Transplantation is Associated with Cardiac Allograft Vasculopathy

Impaired Left Ventricular Systolic Function Early After Heart Transplantation is Associated with Cardiac Allograft Vasculopathy

Evaluation of coronary atheroma by 64-slice multidetector computed tomography: Comparison with intravascular ultrasound and angiography

Vasodilatory Effect of Subsequent Administration of Fasudil, a Rho-Kinase Inhibitor, Surpasses That of Nitroglycerin at the Concentric Coronary Stenosis in Patients With Stable Angina Pectoris

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