(Circulation. 2000;102:2411.)
© 2000 American Heart Association, Inc.
Basic Science Reports |
Minimally Invasive Evaluation of Coronary Microvascular Function by Electron Beam Computed Tomography
i
, MD, PhDFrom the Departments of Physiology and Biophysics (S.M., E.L.R.), and Internal Medicine, Divisions of Hypertension (L.O.L.) and Cardiovascular Diseases (A.L., T.R.B.), Anesthesiology (Z.S.K.), and Diagnostic Radiology (P.F.S.), Mayo Clinic and Foundation, Rochester, Minn.
Correspondence to Erik L. Ritman, MD, PhD, Department of Physiology and Biophysics, Alfred 2-409, Mayo Clinic and Foundation, 200 First St SW, Rochester, MN 55905. E-mail elran{at}mayo.edu
Background—We previously
demonstrated that in vivo electron-beam computed tomography
(EBCT)–based indicator-dilution methods provide an estimate of
intramyocardial blood volume (BV) and perfusion (F), which relate as
BV=aF+b
F, where a characterizes the recruitable (exchange) and b the
nonrecruitable (conduit) component of the myocardial microcirculation.
In the present study, we compared BV and F with
intracoronary Doppler ultrasound–based coronary
blood flow (CBF) as a method for detecting and quantifying differential
responses of these microvascular components to vasoactive drugs in
normal (control) and hypercholesterolemic (HC)
pigs.
Methods and Results—BV and F values were obtained from contrast-enhanced EBCT studies in 14 HC and 14 control pigs. BV, F, and CBF values were obtained at baseline (intracoronary infusion of saline) and after 5 minutes each of intracoronary infusion of adenosine (100 µg · kg-1 · min-1) and nitroglycerin (40 µg/min). BV and CBF reserves in response to adenosine were attenuated in HC pigs compared with controls (90±36% versus 127±42%, P<0.03, and 485±182% versus 688±160%, P<0.01, respectively). The relationship between BV and F showed consistently lower recruitable BV in HC versus control pigs. Nonrecruitable BV reserve in response to adenosine was attenuated in HC compared with controls (77±20% versus 135±28%, P<0.001). Our findings are consistent with HC-induced impairment of intramyocardial resistance vessel function.
Conclusions—EBCT technology allows minimally invasive evaluation of intramyocardial microcirculatory function and permits assessment of microvascular BV distribution in different functional components. This method may be of value in evaluating the coronary microcirculation in pathophysiological states such as hypercholesterolemia.
Key Words: myocardium • microcirculation • blood volume • ultrasonics • hypercholesterolemia
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