Copyright © 1997 by the European Society of Cardiology.
© 1997 The European Society of Cardiology
Mechanisms of adenosine-induced epicardial coronary artery dilatation
Istitulo di Cardiologia, Università Cattolica del Sacro Cuore Rome, Italy
revised 27 September 1996; accepted 2 October 1996.
Correspondence: Filippo Crea. Istituto di Cardiologia, Universita' Cattolica del Sacro Cuore, L.go A. Gemelli, 8, Rome, Italy
Abstract
BACKGROUND: In order to ascertain whether human adenosine-induced dilatation of epicardial arteries is direct or flow-mediated, we compared the effects of intracoronary adenosine infusion on epicardial coronary arteries with those produced by dypiridamole, a selective arteriolar vasodilator.
METHODS AND RESULTS: In 24 patients with angiographically normal coronary arteries, coronary blood flow velocity was measured by a Doppler wire during intracoronary infusion of adenosine or dipyridamole, which is known to increase intramyocardial adenosine concentration. Coronary angiograms were obtained at baseline and immediately after the end of each infusion period; coronary diameters 5 mm distal to the wire tip were measured by computer-assisted quantitative coronary angiography. Peak coronary blood flow velocities during adenosine or dipyridamole infusions were similar (52·0 ± 15·5 and 47·9 ± 24·2 cm. s–1, P=ns). Coronary diameters immediately after adenosine and dipyridamole infusions were similar and both higher than that at baseline (2·80 ± 0·63 and 2·80 ± 0·64 vs 2·44 ± 0·69 mm, P<0·05). The absolute and percentage increases of coronary artery diameters in response to adenosine were highly correlated to coronary blood flow velocity (R=0·622, intercept –0·10 ± 0·14, P=0·002 and R=0·617 intercept –15·2 ± 9·9, P=0·001, respectively); similar correlations were found in response to dipyridamole (R=0·708, intercept –0·44 ± 0·19, P<0·001 and R=0·649, intercept –13·5 ± 8·7, P<0·001, respectively). Finally the absolute and percentage changes of coronary artery diameters caused by adenosine were highly correlated to those caused by dipyridamole (R=0·840, P<0·001 and R=0·836, P<0·001 respectively).
CONCLUSIONS: A significant correlation exists between epicardial coronary vasodilation and coronary blood flow velocity during intracoronary adenosine infusion, thus suggesting that epicardial coronary vasodilation induced by adenosine is predominantly flow-mediated rather than direct. This conclusion is supported by the observation that similar findings were obtained using dipyridamole, which can only dilate epicardial coronary arteries indirectly, through the increase in coronary blood flow velocity caused by the inhibition of intramyocardial adenosine re-uptake.
Key Words: Adenosine • dipyridamole • coronary vasodilation • flow-mediated vasodilation
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  Z. Liu Insulin at physiological concentrations increases microvascular perfusion in human myocardium Am J Physiol Endocrinol Metab, November 1, 2007; 293(5): E1250 - E1255. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. G. Camici and F. Crea Coronary Microvascular Dysfunction N. Engl. J. Med., February 22, 2007; 356(8): 830 - 840. [Full Text] [PDF]
|
|
|
|
 |
|
 R. Lautamaki, K.E. J. Airaksinen, M. Seppanen, J. Toikka, R. Harkonen, M. Luotolahti, R. Borra, J. Sundell, J. Knuuti, and P. Nuutila Insulin Improves Myocardial Blood Flow in Patients With Type 2 Diabetes and Coronary Artery Disease Diabetes, February 1, 2006; 55(2): 511 - 516. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Kjaer, C. Meyer, F. S. Nielsen, H.-H. Parving, and B. Hesse Dipyridamole, Cold Pressor Test, and Demonstration of Endothelial Dysfunction: A PET Study of Myocardial Perfusion in Diabetes J. Nucl. Med., January 1, 2003; 44(1): 19 - 23. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Paiva, J. Laakso, H. Laine, R. Laaksonen, J. Knuuti, and O. T. Raitakari Plasma asymmetric dimethylarginine and hyperemic myocardial blood flow in young subjects with borderline hypertension or familial hypercholesterolemia J. Am. Coll. Cardiol., October 2, 2002; 40(7): 1241 - 1247. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Oskarsson, E. Pesonen, P. Munkhammar, S. Sandstrom, and P. Jogi Normal Coronary Flow Reserve After Arterial Switch Operation for Transposition of the Great Arteries: An Intracoronary Doppler Guidewire Study Circulation, September 24, 2002; 106(13): 1696 - 1702. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Kozakova, F. Galetta, L. Gregorini, G. Bigalli, F. Franzoni, C. Giusti, and C. Palombo Coronary Vasodilator Capacity and Epicardial Vessel Remodeling in Physiological and Hypertensive Hypertrophy Hypertension, September 1, 2000; 36(3): 343 - 349. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. A. Kaufmann, T. Gnecchi-Ruscone, K. P. Schafers, T. F. Luscher, and P. G. Camici Low density lipoprotein cholesterol and coronary microvascular dysfunction in hypercholesterolemia J. Am. Coll. Cardiol., July 1, 2000; 36(1): 103 - 109. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Laine, P. Nuutila, M. Luotolahti, C. Meyer, T. Elomaa, P. Koskinen, T. Rönnemaa, and J. Knuuti Insulin-Induced Increment of Coronary Flow Reserve Is Not Abolished by Dexamethasone in Healthy Young Men J. Clin. Endocrinol. Metab., May 1, 2000; 85(5): 1868 - 1873. [Abstract] [Full Text]
|
|
|
|
|
|
D. Baller, G. Notohamiprodjo, U. Gleichmann, J. Holzinger, R. Weise, and J. Lehmann Improvement in Coronary Flow Reserve Determined by Positron Emission Tomography After 6 Months of Cholesterol-Lowering Therapy in Patients With Early Stages of Coronary Atherosclerosis Circulation, June 8, 1999; 99(22): 2871 - 2875. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
O.-P. Pitkanen, P. Nuutila, O. T. Raitakari, K. Porkka, H. Iida, I. Nuotio, T. Ronnemaa, J. Viikari, M.-R. Taskinen, C. Ehnholm, et al. Coronary Flow Reserve in Young Men With Familial Combined Hyperlipidemia Circulation, April 6, 1999; 99(13): 1678 - 1684. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Laine, O. T. Raitakari, H. Niinikoski, O.-P. Pitkanen, H. Iida, J. Viikari, P. Nuutila, and J. Knuuti Early impairment of coronary flow reserve in young men with borderline hypertension J. Am. Coll. Cardiol., July 1, 1998; 32(1): 147 - 153. [Abstract] [Full Text] [PDF]
|
|