Heterogeneous Vasomotor Responses of Coronary Conduit and Resistance Vessels in Hypertension
Objectives. The purpose of our study was to investigate the relation between conductance and resistance coronary vasomotor responsiveness in hypertensive patients without atherosclerosis. Background. Although similar in morphology, conduit and resistance coronary vessels differ importantly in size,...
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| Veröffentlicht in: | Journal of the American College of Cardiology 1998-02, Vol.31 (2), p.374-382 |
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| creator | Houghton, Jan L Davison, Cathy A Kuhner, Patricia A Torossov, Mikhail T Strogatz, David S Carr, Albert A |
| description | Objectives. The purpose of our study was to investigate the relation between conductance and resistance coronary vasomotor responsiveness in hypertensive patients without atherosclerosis.
Background. Although similar in morphology, conduit and resistance coronary vessels differ importantly in size, function and local environment and appear to be differentially affected in certain disease processes, such as atherosclerosis and hypertension. However, little is known about the effect of hypertension on contiguous coronary conduit and resistance vessels in humans.
Methods. Changes in coronary blood flow (a measure of resistance vessel reactivity) and coronary artery diameter (a measure of conduit vessel reactivity) were investigated in response to graded infusion of the endothelium-dependent agonist acetylcholine (ACh) in 98 patients with normal coronary arteries.
Results. In 31 normotensive, euglycemic patients, conduit and resistance coronary artery responses to intracoronary infusion of ACh were significantly correlated (r = 0.73, p = 1 × 10−6), although eight patients (26%) had constriction of conduit but dilation of resistance arteries at peak effect. In 28 hypertensive patients without left ventricular hypertrophy (LVH), conduit and resistance artery responses to ACh remained significantly correlated (r = 0.5, p = 0.006), although 12 patients (43%) had discordant findings. Finally, in 39 hypertensive patients with LVH, conduit and resistance artery responses to ACh displayed the lowest correlation (r = 0.38, p = 0.02), with 22 patients (56%) demonstrating conduit artery constriction and resistance artery dilation.
Conclusions. Despite angiographically normal coronary arteries, heterogeneous vasomotor responses (dilation and constriction) were demonstrated in contiguous conduit and resistance arteries in normotensive and hypertensive patients referred for cardiac catheterization because of chest pain. In addition to more severe endothelial dysfunction among conduit and resistance arteries, a greater frequency of discordant conduit and resistance artery responses and resistance vessel constriction was found with increasing severity of hypertension. Our study suggests differing mechanisms of endothelium responsiveness to ACh among conduit and resistance coronary arteries. |
| doi_str_mv | 10.1016/S0735-1097(97)00505-6 |
| format | Article |
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Background. Although similar in morphology, conduit and resistance coronary vessels differ importantly in size, function and local environment and appear to be differentially affected in certain disease processes, such as atherosclerosis and hypertension. However, little is known about the effect of hypertension on contiguous coronary conduit and resistance vessels in humans.
Methods. Changes in coronary blood flow (a measure of resistance vessel reactivity) and coronary artery diameter (a measure of conduit vessel reactivity) were investigated in response to graded infusion of the endothelium-dependent agonist acetylcholine (ACh) in 98 patients with normal coronary arteries.
Results. In 31 normotensive, euglycemic patients, conduit and resistance coronary artery responses to intracoronary infusion of ACh were significantly correlated (r = 0.73, p = 1 × 10−6), although eight patients (26%) had constriction of conduit but dilation of resistance arteries at peak effect. In 28 hypertensive patients without left ventricular hypertrophy (LVH), conduit and resistance artery responses to ACh remained significantly correlated (r = 0.5, p = 0.006), although 12 patients (43%) had discordant findings. Finally, in 39 hypertensive patients with LVH, conduit and resistance artery responses to ACh displayed the lowest correlation (r = 0.38, p = 0.02), with 22 patients (56%) demonstrating conduit artery constriction and resistance artery dilation.
Conclusions. Despite angiographically normal coronary arteries, heterogeneous vasomotor responses (dilation and constriction) were demonstrated in contiguous conduit and resistance arteries in normotensive and hypertensive patients referred for cardiac catheterization because of chest pain. In addition to more severe endothelial dysfunction among conduit and resistance arteries, a greater frequency of discordant conduit and resistance artery responses and resistance vessel constriction was found with increasing severity of hypertension. Our study suggests differing mechanisms of endothelium responsiveness to ACh among conduit and resistance coronary arteries.</description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/S0735-1097(97)00505-6</identifier><identifier>PMID: 9462582</identifier><identifier>CODEN: JACCDI</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Acetylcholine - administration & dosage ; Acetylcholine - pharmacology ; Arterial hypertension. Arterial hypotension ; Biological and medical sciences ; Blood and lymphatic vessels ; Cardiology. Vascular system ; Clinical manifestations. Epidemiology. Investigative techniques. Etiology ; Cohort Studies ; Coronary Angiography ; Coronary Artery Disease - physiopathology ; Coronary Circulation - drug effects ; Coronary Circulation - physiology ; Coronary Vessels - drug effects ; Coronary Vessels - pathology ; Coronary Vessels - physiopathology ; Endothelium, Vascular - drug effects ; Endothelium, Vascular - physiopathology ; Female ; Heart Ventricles - pathology ; Humans ; Hypertension - diagnostic imaging ; Hypertension - physiopathology ; Hypertrophy, Left Ventricular - pathology ; Hypertrophy, Left Ventricular - physiopathology ; Infusions, Intra-Arterial ; Male ; Medical sciences ; Microcirculation - drug effects ; Middle Aged ; Myocardial Contraction - drug effects ; Myocardial Contraction - physiology ; Pericardium - drug effects ; Prospective Studies ; Vascular Resistance - drug effects ; Vascular Resistance - physiology ; Vasoconstriction - drug effects ; Vasodilation - drug effects ; Vasomotor System - drug effects ; Vasomotor System - physiopathology</subject><ispartof>Journal of the American College of Cardiology, 1998-02, Vol.31 (2), p.374-382</ispartof><rights>1998 The American College of Cardiology</rights><rights>1998 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c423t-7ee2206d6ca6250e790a36f39614bf623d4e6a4a5fbcd948bfb993e9ea8eea7b3</citedby><cites>FETCH-LOGICAL-c423t-7ee2206d6ca6250e790a36f39614bf623d4e6a4a5fbcd948bfb993e9ea8eea7b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/S0735-1097(97)00505-6$$EHTML$$P50$$Gelsevier$$Hfree_for_read</linktohtml><link.rule.ids>314,780,784,3548,27923,27924,45994</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=2141579$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/9462582$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Houghton, Jan L</creatorcontrib><creatorcontrib>Davison, Cathy A</creatorcontrib><creatorcontrib>Kuhner, Patricia A</creatorcontrib><creatorcontrib>Torossov, Mikhail T</creatorcontrib><creatorcontrib>Strogatz, David S</creatorcontrib><creatorcontrib>Carr, Albert A</creatorcontrib><title>Heterogeneous Vasomotor Responses of Coronary Conduit and Resistance Vessels in Hypertension</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description>Objectives. The purpose of our study was to investigate the relation between conductance and resistance coronary vasomotor responsiveness in hypertensive patients without atherosclerosis.
Background. Although similar in morphology, conduit and resistance coronary vessels differ importantly in size, function and local environment and appear to be differentially affected in certain disease processes, such as atherosclerosis and hypertension. However, little is known about the effect of hypertension on contiguous coronary conduit and resistance vessels in humans.
Methods. Changes in coronary blood flow (a measure of resistance vessel reactivity) and coronary artery diameter (a measure of conduit vessel reactivity) were investigated in response to graded infusion of the endothelium-dependent agonist acetylcholine (ACh) in 98 patients with normal coronary arteries.
Results. In 31 normotensive, euglycemic patients, conduit and resistance coronary artery responses to intracoronary infusion of ACh were significantly correlated (r = 0.73, p = 1 × 10−6), although eight patients (26%) had constriction of conduit but dilation of resistance arteries at peak effect. In 28 hypertensive patients without left ventricular hypertrophy (LVH), conduit and resistance artery responses to ACh remained significantly correlated (r = 0.5, p = 0.006), although 12 patients (43%) had discordant findings. Finally, in 39 hypertensive patients with LVH, conduit and resistance artery responses to ACh displayed the lowest correlation (r = 0.38, p = 0.02), with 22 patients (56%) demonstrating conduit artery constriction and resistance artery dilation.
Conclusions. Despite angiographically normal coronary arteries, heterogeneous vasomotor responses (dilation and constriction) were demonstrated in contiguous conduit and resistance arteries in normotensive and hypertensive patients referred for cardiac catheterization because of chest pain. In addition to more severe endothelial dysfunction among conduit and resistance arteries, a greater frequency of discordant conduit and resistance artery responses and resistance vessel constriction was found with increasing severity of hypertension. Our study suggests differing mechanisms of endothelium responsiveness to ACh among conduit and resistance coronary arteries.</description><subject>Acetylcholine - administration & dosage</subject><subject>Acetylcholine - pharmacology</subject><subject>Arterial hypertension. Arterial hypotension</subject><subject>Biological and medical sciences</subject><subject>Blood and lymphatic vessels</subject><subject>Cardiology. Vascular system</subject><subject>Clinical manifestations. Epidemiology. Investigative techniques. Etiology</subject><subject>Cohort Studies</subject><subject>Coronary Angiography</subject><subject>Coronary Artery Disease - physiopathology</subject><subject>Coronary Circulation - drug effects</subject><subject>Coronary Circulation - physiology</subject><subject>Coronary Vessels - drug effects</subject><subject>Coronary Vessels - pathology</subject><subject>Coronary Vessels - physiopathology</subject><subject>Endothelium, Vascular - drug effects</subject><subject>Endothelium, Vascular - physiopathology</subject><subject>Female</subject><subject>Heart Ventricles - pathology</subject><subject>Humans</subject><subject>Hypertension - diagnostic imaging</subject><subject>Hypertension - physiopathology</subject><subject>Hypertrophy, Left Ventricular - pathology</subject><subject>Hypertrophy, Left Ventricular - physiopathology</subject><subject>Infusions, Intra-Arterial</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Microcirculation - drug effects</subject><subject>Middle Aged</subject><subject>Myocardial Contraction - drug effects</subject><subject>Myocardial Contraction - physiology</subject><subject>Pericardium - drug effects</subject><subject>Prospective Studies</subject><subject>Vascular Resistance - drug effects</subject><subject>Vascular Resistance - physiology</subject><subject>Vasoconstriction - drug effects</subject><subject>Vasodilation - drug effects</subject><subject>Vasomotor System - drug effects</subject><subject>Vasomotor System - physiopathology</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1998</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkFtLHDEUgEOp2FX7E4R5KKU-jOYySSZPIkvbFRYEqz4JIZM5U1JmkzVntuC_b_bCvhYCJ3C-c_sIuWT0mlGmbn5RLWTNqNHfjL6iVFJZqw9kxqRsayGN_khmR-QTOUP8QylVLTOn5NQ0isuWz8jrAibI6TdESBusXhymVZpSrh4B1ykiYJWGap5yii6_l0_sN2GqXOy3RMDJRQ_VCyDCiFWI1eJ9DXmCiCHFC3IyuBHh8yGek-cf35_mi3r58PN-fresfcPFVGsAzqnqlXdlKwraUCfUIIxiTTcoLvoGlGucHDrfm6bths4YAQZcC-B0J87J133fdU5vG8DJrgJ6GEe3u8pqo7ThXBRQ7kGfE2KGwa5zWJXDLKN2a9XurNqtMlvezqpVpe7yMGDTraA_Vh00lvyXQ96hd-OQi5WAR4yzhkltCna7x4or-BsgW_QBisA-ZPCT7VP4zyL_AA0zlbs</recordid><startdate>19980201</startdate><enddate>19980201</enddate><creator>Houghton, Jan L</creator><creator>Davison, Cathy A</creator><creator>Kuhner, Patricia A</creator><creator>Torossov, Mikhail T</creator><creator>Strogatz, David S</creator><creator>Carr, Albert A</creator><general>Elsevier Inc</general><general>Elsevier Science</general><scope>6I.</scope><scope>AAFTH</scope><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>19980201</creationdate><title>Heterogeneous Vasomotor Responses of Coronary Conduit and Resistance Vessels in Hypertension</title><author>Houghton, Jan L ; Davison, Cathy A ; Kuhner, Patricia A ; Torossov, Mikhail T ; Strogatz, David S ; Carr, Albert A</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c423t-7ee2206d6ca6250e790a36f39614bf623d4e6a4a5fbcd948bfb993e9ea8eea7b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1998</creationdate><topic>Acetylcholine - administration & dosage</topic><topic>Acetylcholine - pharmacology</topic><topic>Arterial hypertension. Arterial hypotension</topic><topic>Biological and medical sciences</topic><topic>Blood and lymphatic vessels</topic><topic>Cardiology. Vascular system</topic><topic>Clinical manifestations. Epidemiology. Investigative techniques. Etiology</topic><topic>Cohort Studies</topic><topic>Coronary Angiography</topic><topic>Coronary Artery Disease - physiopathology</topic><topic>Coronary Circulation - drug effects</topic><topic>Coronary Circulation - physiology</topic><topic>Coronary Vessels - drug effects</topic><topic>Coronary Vessels - pathology</topic><topic>Coronary Vessels - physiopathology</topic><topic>Endothelium, Vascular - drug effects</topic><topic>Endothelium, Vascular - physiopathology</topic><topic>Female</topic><topic>Heart Ventricles - pathology</topic><topic>Humans</topic><topic>Hypertension - diagnostic imaging</topic><topic>Hypertension - physiopathology</topic><topic>Hypertrophy, Left Ventricular - pathology</topic><topic>Hypertrophy, Left Ventricular - physiopathology</topic><topic>Infusions, Intra-Arterial</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Microcirculation - drug effects</topic><topic>Middle Aged</topic><topic>Myocardial Contraction - drug effects</topic><topic>Myocardial Contraction - physiology</topic><topic>Pericardium - drug effects</topic><topic>Prospective Studies</topic><topic>Vascular Resistance - drug effects</topic><topic>Vascular Resistance - physiology</topic><topic>Vasoconstriction - drug effects</topic><topic>Vasodilation - drug effects</topic><topic>Vasomotor System - drug effects</topic><topic>Vasomotor System - physiopathology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Houghton, Jan L</creatorcontrib><creatorcontrib>Davison, Cathy A</creatorcontrib><creatorcontrib>Kuhner, Patricia A</creatorcontrib><creatorcontrib>Torossov, Mikhail T</creatorcontrib><creatorcontrib>Strogatz, David S</creatorcontrib><creatorcontrib>Carr, Albert A</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><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>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Houghton, Jan L</au><au>Davison, Cathy A</au><au>Kuhner, Patricia A</au><au>Torossov, Mikhail T</au><au>Strogatz, David S</au><au>Carr, Albert A</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Heterogeneous Vasomotor Responses of Coronary Conduit and Resistance Vessels in Hypertension</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>1998-02-01</date><risdate>1998</risdate><volume>31</volume><issue>2</issue><spage>374</spage><epage>382</epage><pages>374-382</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><coden>JACCDI</coden><abstract>Objectives. The purpose of our study was to investigate the relation between conductance and resistance coronary vasomotor responsiveness in hypertensive patients without atherosclerosis.
Background. Although similar in morphology, conduit and resistance coronary vessels differ importantly in size, function and local environment and appear to be differentially affected in certain disease processes, such as atherosclerosis and hypertension. However, little is known about the effect of hypertension on contiguous coronary conduit and resistance vessels in humans.
Methods. Changes in coronary blood flow (a measure of resistance vessel reactivity) and coronary artery diameter (a measure of conduit vessel reactivity) were investigated in response to graded infusion of the endothelium-dependent agonist acetylcholine (ACh) in 98 patients with normal coronary arteries.
Results. In 31 normotensive, euglycemic patients, conduit and resistance coronary artery responses to intracoronary infusion of ACh were significantly correlated (r = 0.73, p = 1 × 10−6), although eight patients (26%) had constriction of conduit but dilation of resistance arteries at peak effect. In 28 hypertensive patients without left ventricular hypertrophy (LVH), conduit and resistance artery responses to ACh remained significantly correlated (r = 0.5, p = 0.006), although 12 patients (43%) had discordant findings. Finally, in 39 hypertensive patients with LVH, conduit and resistance artery responses to ACh displayed the lowest correlation (r = 0.38, p = 0.02), with 22 patients (56%) demonstrating conduit artery constriction and resistance artery dilation.
Conclusions. Despite angiographically normal coronary arteries, heterogeneous vasomotor responses (dilation and constriction) were demonstrated in contiguous conduit and resistance arteries in normotensive and hypertensive patients referred for cardiac catheterization because of chest pain. In addition to more severe endothelial dysfunction among conduit and resistance arteries, a greater frequency of discordant conduit and resistance artery responses and resistance vessel constriction was found with increasing severity of hypertension. Our study suggests differing mechanisms of endothelium responsiveness to ACh among conduit and resistance coronary arteries.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>9462582</pmid><doi>10.1016/S0735-1097(97)00505-6</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Acetylcholine - administration & dosage Acetylcholine - pharmacology Arterial hypertension. Arterial hypotension Biological and medical sciences Blood and lymphatic vessels Cardiology. Vascular system Clinical manifestations. Epidemiology. Investigative techniques. Etiology Cohort Studies Coronary Angiography Coronary Artery Disease - physiopathology Coronary Circulation - drug effects Coronary Circulation - physiology Coronary Vessels - drug effects Coronary Vessels - pathology Coronary Vessels - physiopathology Endothelium, Vascular - drug effects Endothelium, Vascular - physiopathology Female Heart Ventricles - pathology Humans Hypertension - diagnostic imaging Hypertension - physiopathology Hypertrophy, Left Ventricular - pathology Hypertrophy, Left Ventricular - physiopathology Infusions, Intra-Arterial Male Medical sciences Microcirculation - drug effects Middle Aged Myocardial Contraction - drug effects Myocardial Contraction - physiology Pericardium - drug effects Prospective Studies Vascular Resistance - drug effects Vascular Resistance - physiology Vasoconstriction - drug effects Vasodilation - drug effects Vasomotor System - drug effects Vasomotor System - physiopathology |
| title | Heterogeneous Vasomotor Responses of Coronary Conduit and Resistance Vessels in Hypertension |
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