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Titolo:
Endothelium-dependent and -independent perfusion reserve and the effect ofL-arginine on myocardial perfusion in patients with syndrome X
Autore:
Bottcher, M; Botker, HE; Sonne, H; Nielsen, TT; Czernin, J;
Indirizzi:
Aarhus Univ Hosp, Dept Cardiol B, DK-8200 Aarhus N, Denmark Aarhus Univ Hosp Aarhus Denmark N t Cardiol B, DK-8200 Aarhus N, Denmark Aarhus Univ Hosp, PET Ctr, DK-8200 Aarhus, Denmark Aarhus Univ Hosp Aarhus Denmark DK-8200 PET Ctr, DK-8200 Aarhus, Denmark UnivsCalif Los Angeles, Sch Med, Dept Mol & Med Pharmacol, Div Nucl Med, Lo Univ Calif Los Angeles Los Angeles CA USA 90095 armacol, Div Nucl Med, Lo
Titolo Testata:
CIRCULATION
fascicolo: 14, volume: 99, anno: 1999,
pagine: 1795 - 1801
SICI:
0009-7322(19990413)99:14<1795:EA-PRA>2.0.ZU;2-M
Fonte:
ISI
Lingua:
ENG
Soggetto:
NORMAL CORONARY-ARTERIES; POSITRON EMISSION TOMOGRAPHY; PECTORIS LIKE PAIN; ANGINA-PECTORIS; BLOOD-FLOW; CHEST PAIN; MICROVASCULAR ANGINA; N-13 AMMONIA; INSULIN-RESISTANCE; NITRIC-OXIDE;
Keywords:
blood flow; L-arginine; angina; syndrome X; tomography;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
42
Recensione:
Indirizzi per estratti:
Indirizzo: Bottcher, M Aarhus Univ Hosp, Dept Cardiol B, DK-8200 Aarhus N, Denmark Aarhus Univ Hosp Aarhus Denmark N DK-8200 Aarhus N, Denmark
Citazione:
M. Bottcher et al., "Endothelium-dependent and -independent perfusion reserve and the effect ofL-arginine on myocardial perfusion in patients with syndrome X", CIRCULATION, 99(14), 1999, pp. 1795-1801

Abstract

Background-Impaired vasodilatation capacity in patients with angina pectoris and a normal coronary arteriogram (syndrome X [SX]) has been reported. Most studies report on the response in epicardial vessels. This does not necessarily reflect compromised myocardial microcirculation. Lack of the NO precursor L-arginine has been suggested as a possible cause. Methods and Results-Myocardial blood flow (MBF) was measured, using PET, at rest (MBF-rest) and during intravenous dipyridamole (MBF-DIP) in 25 women(mean age 53+/-7 years) with SX. Thirty healthy volunteers served as controls. One group (A) consisted of 15 age-matched female volunteers (54+/-10 years). The other control group consisted of 15 young healthy women (B; 24+/-5 years). In 12 SX patients, MBF-rest and MBF during cold presser testing were also measured after infusion of L-arginine (6.7 g/min for 45 minutes). The increase in MBF after cold presser testing was similar in the SX groupcompared with controls. L-arginine did not affect MBF-rest (0.83+/-0.14 versus 0.89+/-0.13 mL . g(-1) . min(-1)) or MBF after cold presser test (0.95/-0.10 versus 1.03+/-0.17 mL . g(-1) . min(-1)), In contrast, the hyperemic response to DIP was blunted compared with the group A controls (1.68+/-0.49 versus 2.34+/-0.45 mt . g(-1) . min(-1), P<0.05); this resulted in a significant reduction of the coronary flow reserve in SX patients relative to controls (2.03+/-0.53 versus 2.96+/-0.63 mt . g(-1) . min(-1), P<0.01). Conclusions-In patients with SX, the microcirculatory response to cold, reflecting the endothelium function, is normal and unaltered by intravenous L-arginine. This suggests preserved microcirculatory endothelial function. However, a markedly attenuated hyperemic flow and flow reserve after DIP suggest a dysfunction of the adenosine-mediated endothelium-independent vasodilatation at the microcirculatory level in these patients.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 25/01/20 alle ore 18:57:43