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Acute effects of urinary bladder distention on the coronary circulation in patients with early atherosclerosis

Tsung-Ming Lee, MD, FESC^*, Sheng-Fang Su, PhD, Ming-Fong Chen, MD, PhD, FACC, FESC^* and Chang-Her Tsai, MD, PhD

^* Department of Internal Medicine, Cardiology Section, National Taiwan University Hospital, Taipei, Taiwan
Department of Surgery, Cardiology Section, National Taiwan University Hospital, Taipei, Taiwan
College of Medicine, National Cheng Kung University, Tainan, Taiwan

View larger version (74K): [in a new window]   Figure 1 Cinearteriogram frames and coronary diameter measurements in a 65-year-old man with ECG ischemic changes (from group 1 without pretreatment with an alpha1 blocker). Coronary vasoconstriction was noted during urinary bladder distention at the stenotic segment (arrowhead), which was relieved after intracoronary nitroglycerin administration. A, Baseline. B, During bladder distention with an intravesical pressure of 20 mm Hg. C, After intracoronary injection of nitroglycerin (200 µg) with an intravesical pressure 20 mm Hg.

View larger version (17K): [in a new window]   Figure 2 The epicardial coronary diameter in the stenotic segments (A), coronary diameter in the normal segments (B), coronary blood flow (C) and resistance (D) in response to bladder distention and nitroglycerin (NTG) are shown as relative changes from respective baseline values in patients without pretreatment (open circles) or in those pretreated doxazosin (solid circles). Data are expressed as the mean value ± SD. Probability values are for the significance of the two groups with respect to coronary dynamic data during bladder distention and response to nitroglycerin.