Influence of age and hemodynamics on myocardial blood flow and flow reserve
Aging is associated with changes of the systolic blood pressure that may increase cardiac work and myocardial blood flow at rest and reduce the myocardial flow reserve. This might be misinterpreted as age-related impairment of the coronary vasodilator capacity. Myocardial blood flow was quantified a...
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| Veröffentlicht in: | Circulation (New York, N.Y.) N.Y.), 1993-07, Vol.88 (1), p.62-69 |
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| creator | CZERNIN, J MÜLLER, P SAMMY CHAN BRUNKEN, R. C PORENTA, G KRIVOKAPICH, J CHEN, K CHAN, A PHELPS, M. E SCHELBERT, H. R |
| description | Aging is associated with changes of the systolic blood pressure that may increase cardiac work and myocardial blood flow at rest and reduce the myocardial flow reserve. This might be misinterpreted as age-related impairment of the coronary vasodilator capacity.
Myocardial blood flow was quantified at rest and after administration of intravenous dipyridamole in 40 healthy volunteers (12 women and 28 men) with 13N-ammonia and positron emission tomography. Eighteen of the normal subjects were less than and 22 were older than 50 years (31 +/- 9 versus 64 +/- 9 years). The resting rate-pressure product was lower in the younger than in the older subjects (6895 +/- 1070 versus 8634 +/- 1890; P < 0.01). Myocardial blood flow at rest averaged 0.76 +/- 0.17 mL.min-1.g-1 in the younger volunteers and 0.92 +/- 0.25 mL.min-1.g-1 in the older volunteers (P < 0.05). Hyperemic blood flows did not differ between younger and older subjects (3.0 +/- 0.8 versus 2.7 +/- 0.6 mL.min-1.g-1; P = NS); however, minimal coronary resistance was higher in the older subjects. Corrected for indexes of coronary driving pressure, hyperemic flow was lower in older than in younger normal subjects. The higher resting blood flows combined with similar hyperemic flows resulted in a lower myocardial flow reserve in the older than in the younger normal subjects (4.1 +/- 0.9 versus 3.0 +/- 0.70; P < 0.0001). The flow reserve was more closely correlated with resting than with hyperemic blood flows.
Aging does not alter significantly dipyridamole-induced hyperemic flows; although coronary vascular resistance after dipyridamole was somewhat increased in older subjects. The gradual decline of the myocardial blood flow reserve correlates with an age-related increase of baseline myocardial work and blood flow. These findings suggest that the reduced flow reserve with age is primarily due to increased cardiac work and blood flow at rest rather than to an abnormal vasodilator capacity. |
| doi_str_mv | 10.1161/01.cir.88.1.62 |
| format | Article |
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Myocardial blood flow was quantified at rest and after administration of intravenous dipyridamole in 40 healthy volunteers (12 women and 28 men) with 13N-ammonia and positron emission tomography. Eighteen of the normal subjects were less than and 22 were older than 50 years (31 +/- 9 versus 64 +/- 9 years). The resting rate-pressure product was lower in the younger than in the older subjects (6895 +/- 1070 versus 8634 +/- 1890; P < 0.01). Myocardial blood flow at rest averaged 0.76 +/- 0.17 mL.min-1.g-1 in the younger volunteers and 0.92 +/- 0.25 mL.min-1.g-1 in the older volunteers (P < 0.05). Hyperemic blood flows did not differ between younger and older subjects (3.0 +/- 0.8 versus 2.7 +/- 0.6 mL.min-1.g-1; P = NS); however, minimal coronary resistance was higher in the older subjects. Corrected for indexes of coronary driving pressure, hyperemic flow was lower in older than in younger normal subjects. The higher resting blood flows combined with similar hyperemic flows resulted in a lower myocardial flow reserve in the older than in the younger normal subjects (4.1 +/- 0.9 versus 3.0 +/- 0.70; P < 0.0001). The flow reserve was more closely correlated with resting than with hyperemic blood flows.
Aging does not alter significantly dipyridamole-induced hyperemic flows; although coronary vascular resistance after dipyridamole was somewhat increased in older subjects. The gradual decline of the myocardial blood flow reserve correlates with an age-related increase of baseline myocardial work and blood flow. These findings suggest that the reduced flow reserve with age is primarily due to increased cardiac work and blood flow at rest rather than to an abnormal vasodilator capacity.</description><identifier>ISSN: 0009-7322</identifier><identifier>EISSN: 1524-4539</identifier><identifier>DOI: 10.1161/01.cir.88.1.62</identifier><identifier>PMID: 8319357</identifier><identifier>CODEN: CIRCAZ</identifier><language>eng</language><publisher>Hagerstown, MD: Lippincott Williams & Wilkins</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Aging - physiology ; Ammonia ; Biological and medical sciences ; Coronary Circulation - physiology ; Coronary Vessels - physiology ; Dipyridamole ; Female ; Fundamental and applied biological sciences. Psychology ; Heart - diagnostic imaging ; Hemodynamics - physiology ; Hemodynamics. Rheology ; Humans ; Male ; Middle Aged ; Nitrogen Radioisotopes ; Tomography, Emission-Computed ; Vertebrates: cardiovascular system</subject><ispartof>Circulation (New York, N.Y.), 1993-07, Vol.88 (1), p.62-69</ispartof><rights>1993 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c464t-fc03845bb98c2e145e343e2a2eb332edddde36bc0036bfd5304c92232afa51123</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,3674,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=4847619$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/8319357$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>CZERNIN, J</creatorcontrib><creatorcontrib>MÜLLER, P</creatorcontrib><creatorcontrib>SAMMY CHAN</creatorcontrib><creatorcontrib>BRUNKEN, R. C</creatorcontrib><creatorcontrib>PORENTA, G</creatorcontrib><creatorcontrib>KRIVOKAPICH, J</creatorcontrib><creatorcontrib>CHEN, K</creatorcontrib><creatorcontrib>CHAN, A</creatorcontrib><creatorcontrib>PHELPS, M. E</creatorcontrib><creatorcontrib>SCHELBERT, H. R</creatorcontrib><title>Influence of age and hemodynamics on myocardial blood flow and flow reserve</title><title>Circulation (New York, N.Y.)</title><addtitle>Circulation</addtitle><description>Aging is associated with changes of the systolic blood pressure that may increase cardiac work and myocardial blood flow at rest and reduce the myocardial flow reserve. This might be misinterpreted as age-related impairment of the coronary vasodilator capacity.
Myocardial blood flow was quantified at rest and after administration of intravenous dipyridamole in 40 healthy volunteers (12 women and 28 men) with 13N-ammonia and positron emission tomography. Eighteen of the normal subjects were less than and 22 were older than 50 years (31 +/- 9 versus 64 +/- 9 years). The resting rate-pressure product was lower in the younger than in the older subjects (6895 +/- 1070 versus 8634 +/- 1890; P < 0.01). Myocardial blood flow at rest averaged 0.76 +/- 0.17 mL.min-1.g-1 in the younger volunteers and 0.92 +/- 0.25 mL.min-1.g-1 in the older volunteers (P < 0.05). Hyperemic blood flows did not differ between younger and older subjects (3.0 +/- 0.8 versus 2.7 +/- 0.6 mL.min-1.g-1; P = NS); however, minimal coronary resistance was higher in the older subjects. Corrected for indexes of coronary driving pressure, hyperemic flow was lower in older than in younger normal subjects. The higher resting blood flows combined with similar hyperemic flows resulted in a lower myocardial flow reserve in the older than in the younger normal subjects (4.1 +/- 0.9 versus 3.0 +/- 0.70; P < 0.0001). The flow reserve was more closely correlated with resting than with hyperemic blood flows.
Aging does not alter significantly dipyridamole-induced hyperemic flows; although coronary vascular resistance after dipyridamole was somewhat increased in older subjects. The gradual decline of the myocardial blood flow reserve correlates with an age-related increase of baseline myocardial work and blood flow. These findings suggest that the reduced flow reserve with age is primarily due to increased cardiac work and blood flow at rest rather than to an abnormal vasodilator capacity.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aging - physiology</subject><subject>Ammonia</subject><subject>Biological and medical sciences</subject><subject>Coronary Circulation - physiology</subject><subject>Coronary Vessels - physiology</subject><subject>Dipyridamole</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Heart - diagnostic imaging</subject><subject>Hemodynamics - physiology</subject><subject>Hemodynamics. Rheology</subject><subject>Humans</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Nitrogen Radioisotopes</subject><subject>Tomography, Emission-Computed</subject><subject>Vertebrates: cardiovascular system</subject><issn>0009-7322</issn><issn>1524-4539</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1993</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNo9kEtPwzAQhC0EKqVw5YbkA-KW4GfiHFHFo6ISEoKz5ThrCHLiYjeg_ntCW3UPu7OaT3MYhC4pySkt6C2huW1jrlRO84IdoSmVTGRC8uoYTQkhVVZyxk7RWUpf41vwUk7QRHFacVlO0fOid36A3gIODpsPwKZv8Cd0odn0pmttwqHH3SZYE5vWeFz7EBrsfPjdklsRIUH8gXN04oxPcLG_M_T-cP82f8qWL4-L-d0ys6IQ68xZwpWQdV0py4AKCVxwYIZBzTmDZhzgRW0JGbdrJCfCVoxxZpyRlDI-Qze73FUM3wOkte7aZMF700MYki6looyoYgTzHWhjSCmC06vYdiZuNCX6vz1NqJ4vXrVSmuriP_lqnzzUHTQHfF_X6F_vfZOs8S6a3rbpgAklymIk_wC-Pndt</recordid><startdate>19930701</startdate><enddate>19930701</enddate><creator>CZERNIN, J</creator><creator>MÜLLER, P</creator><creator>SAMMY CHAN</creator><creator>BRUNKEN, R. C</creator><creator>PORENTA, G</creator><creator>KRIVOKAPICH, J</creator><creator>CHEN, K</creator><creator>CHAN, A</creator><creator>PHELPS, M. E</creator><creator>SCHELBERT, H. R</creator><general>Lippincott Williams & Wilkins</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19930701</creationdate><title>Influence of age and hemodynamics on myocardial blood flow and flow reserve</title><author>CZERNIN, J ; MÜLLER, P ; SAMMY CHAN ; BRUNKEN, R. C ; PORENTA, G ; KRIVOKAPICH, J ; CHEN, K ; CHAN, A ; PHELPS, M. E ; SCHELBERT, H. R</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c464t-fc03845bb98c2e145e343e2a2eb332edddde36bc0036bfd5304c92232afa51123</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1993</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aging - physiology</topic><topic>Ammonia</topic><topic>Biological and medical sciences</topic><topic>Coronary Circulation - physiology</topic><topic>Coronary Vessels - physiology</topic><topic>Dipyridamole</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Heart - diagnostic imaging</topic><topic>Hemodynamics - physiology</topic><topic>Hemodynamics. Rheology</topic><topic>Humans</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Nitrogen Radioisotopes</topic><topic>Tomography, Emission-Computed</topic><topic>Vertebrates: cardiovascular system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>CZERNIN, J</creatorcontrib><creatorcontrib>MÜLLER, P</creatorcontrib><creatorcontrib>SAMMY CHAN</creatorcontrib><creatorcontrib>BRUNKEN, R. C</creatorcontrib><creatorcontrib>PORENTA, G</creatorcontrib><creatorcontrib>KRIVOKAPICH, J</creatorcontrib><creatorcontrib>CHEN, K</creatorcontrib><creatorcontrib>CHAN, A</creatorcontrib><creatorcontrib>PHELPS, M. E</creatorcontrib><creatorcontrib>SCHELBERT, H. R</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Circulation (New York, N.Y.)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>CZERNIN, J</au><au>MÜLLER, P</au><au>SAMMY CHAN</au><au>BRUNKEN, R. C</au><au>PORENTA, G</au><au>KRIVOKAPICH, J</au><au>CHEN, K</au><au>CHAN, A</au><au>PHELPS, M. E</au><au>SCHELBERT, H. R</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Influence of age and hemodynamics on myocardial blood flow and flow reserve</atitle><jtitle>Circulation (New York, N.Y.)</jtitle><addtitle>Circulation</addtitle><date>1993-07-01</date><risdate>1993</risdate><volume>88</volume><issue>1</issue><spage>62</spage><epage>69</epage><pages>62-69</pages><issn>0009-7322</issn><eissn>1524-4539</eissn><coden>CIRCAZ</coden><abstract>Aging is associated with changes of the systolic blood pressure that may increase cardiac work and myocardial blood flow at rest and reduce the myocardial flow reserve. This might be misinterpreted as age-related impairment of the coronary vasodilator capacity.
Myocardial blood flow was quantified at rest and after administration of intravenous dipyridamole in 40 healthy volunteers (12 women and 28 men) with 13N-ammonia and positron emission tomography. Eighteen of the normal subjects were less than and 22 were older than 50 years (31 +/- 9 versus 64 +/- 9 years). The resting rate-pressure product was lower in the younger than in the older subjects (6895 +/- 1070 versus 8634 +/- 1890; P < 0.01). Myocardial blood flow at rest averaged 0.76 +/- 0.17 mL.min-1.g-1 in the younger volunteers and 0.92 +/- 0.25 mL.min-1.g-1 in the older volunteers (P < 0.05). Hyperemic blood flows did not differ between younger and older subjects (3.0 +/- 0.8 versus 2.7 +/- 0.6 mL.min-1.g-1; P = NS); however, minimal coronary resistance was higher in the older subjects. Corrected for indexes of coronary driving pressure, hyperemic flow was lower in older than in younger normal subjects. The higher resting blood flows combined with similar hyperemic flows resulted in a lower myocardial flow reserve in the older than in the younger normal subjects (4.1 +/- 0.9 versus 3.0 +/- 0.70; P < 0.0001). The flow reserve was more closely correlated with resting than with hyperemic blood flows.
Aging does not alter significantly dipyridamole-induced hyperemic flows; although coronary vascular resistance after dipyridamole was somewhat increased in older subjects. The gradual decline of the myocardial blood flow reserve correlates with an age-related increase of baseline myocardial work and blood flow. These findings suggest that the reduced flow reserve with age is primarily due to increased cardiac work and blood flow at rest rather than to an abnormal vasodilator capacity.</abstract><cop>Hagerstown, MD</cop><pub>Lippincott Williams & Wilkins</pub><pmid>8319357</pmid><doi>10.1161/01.cir.88.1.62</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Aging - physiology Ammonia Biological and medical sciences Coronary Circulation - physiology Coronary Vessels - physiology Dipyridamole Female Fundamental and applied biological sciences. Psychology Heart - diagnostic imaging Hemodynamics - physiology Hemodynamics. Rheology Humans Male Middle Aged Nitrogen Radioisotopes Tomography, Emission-Computed Vertebrates: cardiovascular system |
| title | Influence of age and hemodynamics on myocardial blood flow and flow reserve |
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