TY - JOUR
T1 - Persistence of arterial functional abnormalities after successful coronary revascularization
AU - Giannattasio, Cristina
AU - Capra, Anna Cm
AU - Calchera, Ivan
AU - Colombo, Virgilio
AU - Cesana, Francesca
AU - Nava, Stefano
AU - Maloberti, Alessandro
AU - Alloni, Marta
AU - Facchetti, Rita
AU - Trocino, Giuseppe
AU - Grassi, Guido
AU - Paolini, Giovanni
AU - Mancia, Giuseppe
PY - 2011/7
Y1 - 2011/7
N2 - 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.
AB - 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.
KW - arterial stiffness
KW - coronary atherosclerosis
KW - coronary revascularization
KW - diastolic dysfunction
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U2 - 10.1097/HJH.0b013e328347a0e3
DO - 10.1097/HJH.0b013e328347a0e3
M3 - Article
C2 - 21558954
AN - SCOPUS:79958765537
VL - 29
SP - 1374
EP - 1379
JO - Journal of Hypertension
JF - Journal of Hypertension
SN - 0263-6352
IS - 7
ER -