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European Heart Journal 1994 15(3):369-376;
Copyright © 1994 by the European Society of Cardiology.
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© 1994 The European Society of Cardiology

Chrome congestive heart failure

Catheter-delivered high intensity, low frequency ultrasound induces vasodilation in vivo

W. STEFFEN*,, D. CUMBERLAND, P. GAINES, H. LUO, H. NITA, G. MAURER, M. C. FISHBEIN and R. J. SIEGEL

From the Divisions of Cardiology and Anatomic Pathology, Cedars Sinai Medical Center 8700 Beverly Boulevard, Los Angeles, CA, 90048, U.S.A.

Received 21 June 1993; revised 2 November 1993; .

Correspondence: Robert J. Siegel, MD, FACC, Division of Cardiology Rm 5314, 8700 Beverly Boulevard, Los Angeles, CA. 90048, U.S.A.

Abstract

This study investigated the effect of intravascular high intensity, low frequency catheter-delivered ultrasound on vasomotor behaviour in vivo. Catheter-delivered therapeutic ultrasound induces endothelium-independent vasodilation in vitro. To study this effect in vivo we analysed the angiograms of canine coronaries and human femoropopliteal arteries before and after ultrasound exposure. Vasomotor behaviour was studied using a computer edge detection program. We analysed the angiograms of. (1) eight canine left coronary arteries before and after ultrasound; (2) eight canine left coronaries only subjected to serial angiograms, and three canine left coronary arteries of two dogs after passing the unactivated ultrasound probe down the coronary artery infusing saline at a rate of 10–20 ml. min–1, which served as controls, and (3) eight angiographically normal human arterial sites proximal to occlusions in eight femoropopliteal arteries of patients undergoing ultrasound angioplasty for peripheral vascular disease.

Vessel diameter of canine coronaries after ultrasound exposure increased from 2·3±0·3 mm to 2·8±0·3 mm (21±2·3%) (P<0·01). There was no change in vascular diameter in controls after multiple angiograms (2·4±0·3 mm vs 2·5±0·2 mm (4·2±0·2%) (P=ns). Average vessel dimeter after passage of the unactivated probe with saline infusion decreased in the left anterior descending coronary artery from 3·66mm to 3·13 mm, and in the left circumflex coronary artery from 2·88 mm to 2·62 mm. Vessel diameter in human femoropopliteal arteries increased from 3·2±02 mm to 3·6±0·5 mm or by 14·3±2·9% respectively (P<0·01) after exposure to ultrasound energy.

Therapeutic intravascular ultrasound induces vasodilation in canine coronaries and in human femoropopliteal arteries. The vasodilatory effect may result in enhanced arterial run-off and could potentially reduce the risk of ischaemia as well as acute reocclus:on during intravascular intervention.

Key Words: Vasodilation • ultrasound angioplasty • smooth muscle cell • nitrous oxide


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