JACC
HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
 QUICK SEARCH:   [advanced]


     


J Am Coll Cardiol, 1997; 30:65-70
© 1997 by the American College of Cardiology Foundation
This Article
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Torres, M.
Right arrow Articles by Parodi, O
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Torres, M.
Right arrow Articles by Parodi, O

Flow-function relation in patients with chronic coronary artery disease and reduced regional function. A positron emission tomographic and two-dimensional echocardiographic study with coronary vasodilator stress

MA Torres, E Picano, G Parodi, R Sicari, F Veglia, A Giorgetti, P Marzullo, and O Parodi

CNR Institute of Clinical Physiology, Pisa, Italy.

OBJECTIVES: We sought to elucidate the flow-function relation in chronic postischemic dysfunction during vasodilator stress. BACKGROUND: In patients with ischemia and regional dysfunction, stress echocardiography can elicit three responses in the dysfunctioning segments: no change, improvement or worsening. The physiology underlying these responses is unclear. METHODS: Seventeen patients with ischemia and left ventricular dysfunction underwent evaluation of regional function by two-dimensional echocardiography and myocardial blood flow by positron emission tomography and 13N-ammonia. Flow (ml/min per g) and function (regional wall motion score [RWMS] from 1 = normal to 4 = dyskinetic) were evaluated both at rest and after dipyridamole (0.56 mg/kg body weight over 4 min). RESULTS: In 45 normal segments, rest to dipyridamole flow increased from 0.83 +/- 0.22 (mean +/- 1 SD) to 1.87 +/- 0.90 (p < 0.01) with a hyperkinetic contraction pattern. Among dysfunctioning segments, responders (n = 11) showed an upsloping flow-function curve during stress (i.e., increased function [RWMS rest 2.5 +/- 0.5 vs. dipyridamole 1.2 +/- 0.4] and increased flow [rest 0.69 +/- 0.30 vs. dipyridamole 1.89 +/- 1.43, p < 0.01]); nonresponders (n = 20) had a flat flow-function curve during dipyridamole (i.e., fixed function [RWMS rest and dipyridamole 2.6 +/- 0.5] and no flow increase [rest 0.64 +/- 0.24 vs. dipyridamole 0.87 +/- 0.51, p = NS): Ischemic segments (n = 9) exhibited a downsloping flow-function curve during dipyridamole (i.e., worsened function [RWMS rest 2 +/- 0.5, dipyridamole 3.1 +/- 0.6] and no significant flow change [rest 0.67 +/- 0.29 vs. dipyridamole 0.79 +/- 0.23, p = NS]). CONCLUSIONS: Myocardial segments with rest dysfunction and a contractile reserve elicitable by a vasodilator stress more often exhibit residual flow reserve, whereas segments with a fixed or worsening mechanical response during stress show a flat flow response.


This article has been cited by other articles:


Home page
Eur Heart JHome page
B. Beleslin, M. Ostojic, A. Djordjevic-Dikic, V. Vukcevic, S. Stojkovic, M. Nedeljkovic, G. Stankovic, D. Orlic, N. Milic, J. Stepanovic, et al.
The value of fractional and coronary flow reserve in predicting myocardial recovery in patients with previous myocardial infarction
Eur. Heart J., September 30, 2008; (2008) ehn418v1.
[Abstract] [Full Text] [PDF]


Home page
Eur Heart JHome page
R Sicari, A Ripoli, E Picano, A.C Borges, A Varga, W Mathias, L Cortigiani, R Bigi, J Heyman, S Polimeno, et al.
The prognostic value of myocardial viability recognized by low dose dipyridamole echocardiography in patients with chronic ischaemic left ventricular dysfunction
Eur. Heart J., May 2, 2001; 22(10): 837 - 844.
[Abstract] [PDF]


Home page
J Am Coll CardiolHome page
H. Wiggers, M. Noreng, P. K. Paulsen, M. Bottcher, H. Egeblad, T. T. Nielsen, and H. E. Botker
Energy stores and metabolites in chronic reversibly and irreversibly dysfunctional myocardium in humans
J. Am. Coll. Cardiol., January 1, 2001; 37(1): 100 - 108.
[Abstract] [Full Text] [PDF]


Home page
Physiol. Rev.Home page
G. HEUSCH
Hibernating Myocardium
Physiol Rev, October 1, 1998; 78(4): 1055 - 1085.
[Abstract] [Full Text] [PDF]




HOME SUBSCRIPTIONS CURRENT ISSUE PAST ISSUES CARDIOSOURCE SEARCH HELP FEEDBACK
Copyright © 1997 by the American College of Cardiology Foundation.