Persistence of arterial functional abnormalities after successful coronary revascularization

Cristina Giannattasio, Anna Cm Capra, Ivan Calchera, Virgilio Colombo, Francesca Cesana, Stefano Nava, Alessandro Maloberti, Marta Alloni, Rita Facchetti, Giuseppe Trocino, Guido Grassi, Giovanni Paolini, Giuseppe Mancia

Research output: Contribution to journalArticlepeer-review

Abstract

Background: In patients with myocardial ischemia and coronary atherosclerosis, arterial stiffness and endothelial function are impaired. Whether these alterations can be favorably affected by successful coronary revascularization is debated. Methods: We studied 39 hospitalized patients 59.3 ± 3.2 years old (mean ± SEM). In 21 patients with angiographic evidence of significant coronary artery stenosis, revascularization procedures were performed (stenting n = 11 and bypass surgery n = 10). The remaining patients had no significant stenosis and thus served as controls. Prerevascularization measurements included carotido-femoral pulse wave velocity (PWV), radial artery flow-mediated vasodilatation and a complete echocardiographic examination. The same measurements were performed 6 months later. Pharmacological treatment consisted of different cardiovascular drugs and remained substantially unchanged over the 6-month follow-up period. Results: With the exception of an increased left ventricular mass index (LVMI; 130 ± 5.3 versus 105.8 ± 7.2 g/m, P <0.05) and a lower Em/Am (0.6 ± 0.01 and 0.8 ± 0.01 respectively, P <0.05) observed in patients with coronary stenosis, all other hemodynamic, cardiac and vascular variables were similar in the two groups. Following the 6-month follow-up period, all variables remained substantially unchanged, with the exception, in revascularized patients, of a significant reduction in LVMI (-12%, P <0.05) and an improvement in Tissue Doppler Imaging-measured diastolic function (Em/Am + 30%, P <0.05). This was not associated, however, with any significant change in PWV and in flow-mediated vasodilatation. Conclusion: Cardiac revascularization has no effect on arterial function, assessed either as arterial stiffness or as flow-mediated vasodilatation. On the contrary, the improvement in coronary blood flow triggers local cardiac changes, namely, a reduction in LVMI and an improvement in diastolic function.

Original languageEnglish
Pages (from-to)1374-1379
Number of pages6
JournalJournal of Hypertension
Volume29
Issue number7
DOIs
Publication statusPublished - Jul 2011

Keywords

  • arterial stiffness
  • coronary atherosclerosis
  • coronary revascularization
  • diastolic dysfunction

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

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