Effects of selective α1- and α2-adrenergic blockade on coronary flow reserve after coronary stenting

Luisa Gregorini, Jean Marco, Bruno Farah, Monique Bernies, Carlo Palombo, Michaela Kozàkovà, Irene M. Bossi, Bernard Cassagneau, Jean Fajadet, Carlo Di Mario, Remo Albiero, Massimo Cugno, Adalberto Grossi, Gerd Heusch

Research output: Contribution to journalArticle

Abstract

Background - Coronary flow reserve (CFR) is not normalized shortly after coronary stenting. We hypothesized that α-adrenergic coronary vasoconstriction acts to limit CFR. Methods and Results - We assessed flow velocity by Doppler wires and cross-sectional area by angiography in 46 patients undergoing coronary culprit lesion stenting (81-4% stenosis). Hyperemia was induced by adenosine (24 μg IC or 140 μg/kg per minute IV) before and after stenting. Finally, either the α1-antagonist urapidil (10 mg IC) or the α2-antagonist yohimbine (3 mg IC) was randomly combined with adenosine. In 8 subjects with angiographically normal coronary arteries, CFR was increased from 3.21±0.30 to 3.74±0.43 by yohimbine and to 4.58±0.65 by urapidil, respectively (P=0.0001). Patients were divided according to the cutoff of CFR ≥3.0 (n = 18) or 2.5 (n=28). Revascularization per se did not change CFR. However, 15 minutes after stenting, CFR decreased to 2.05±0.55 from CFR 3.64±0.58, whereas in patients with CFR 2.39±0.51, it remained unchanged. Yohimbine improved CFR to 3.26±0.42 and to 3.41±0.58 in patients with >3.0 and

Original languageEnglish
Pages (from-to)2901-2907
Number of pages7
JournalCirculation
Volume106
Issue number23
DOIs
Publication statusPublished - Dec 3 2002

Keywords

  • Adenosine
  • Blood flow
  • Microcirculation
  • Nervous system, sympathetic
  • Receptors, adrenergic, alpha

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

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    Gregorini, L., Marco, J., Farah, B., Bernies, M., Palombo, C., Kozàkovà, M., Bossi, I. M., Cassagneau, B., Fajadet, J., Di Mario, C., Albiero, R., Cugno, M., Grossi, A., & Heusch, G. (2002). Effects of selective α1- and α2-adrenergic blockade on coronary flow reserve after coronary stenting. Circulation, 106(23), 2901-2907. https://doi.org/10.1161/01.CIR.0000040998.88272.A7