Persistent but reversible coronary microvascular dysfunction after bypass grafting

Nicos Spyrou, Masood A. Khan, Stuart D. Rosen, Rodney Foale, D. Wyn Davies, Franco Sogliani, Rex De Lisle Stanbridge, Paolo G. Camici

Research output: Contribution to journalArticlepeer-review

Abstract

The effect of coronary artery bypass grafting (CABG) on absolute myocardial blood flow (MBF) has not been investigated previously. MBF (ml·min -1·g -1) was measured at rest and during hyperemia (0.56 mg/kg iv dipyridamole) using H 2 15O and positron emission tomography in eight patients with three-vessel disease before surgery and 1 and 6 mo after full revascularization. Baseline MBF was 0.87 ± 0.12 preoperatively and 1.04 ± 0.14 and 0.95 ± 0.13 at 1 and 6 mo after CABG, respectively (P <0.05, 6 mo vs. preoperatively). Hyperemic MBF was 1.36 ± 0.28 preoperatively and increased to 1.98 ± 0.50 and 2.45 ± 0.64 at 1 and 6 mo after CABG, respectively (P <0.01, 6 mo vs. preoperatively). Coronary vasodilator reserve (hyperemic/baseline MBF) increased from 1.59 ± 0.40 preoperatively to 1.93 ± 0.13 and 2.57 ± 0.49 at 1 and 6 mo, respectively (P <0.05, 6 mo vs. preoperatively). Minimal (dipyridamole) coronary resistance (mmHg·min·g -1·ml -1) fell progressively from 59.37 ± 14.56 before surgery to a nadir of 35.76 ± 10.12 at 6 mo after CABG (P <0.01 vs. preoperatively). The results of the present study confirm that CABG improves coronary vasodilator reserve progressively as a result of reduction in minimal coronary resistance. These data suggest persistent microvascular dysfunction that recovers slowly after surgery.

Original languageEnglish
JournalAmerican Journal of Physiology - Heart and Circulatory Physiology
Volume279
Issue number6 48-6
Publication statusPublished - 2000

Keywords

  • Coronary artery disease
  • Coronary microcirculation
  • Coronary vasodilator reserve
  • Myocardial blood flow
  • Positron emission tomography

ASJC Scopus subject areas

  • Physiology
  • Physiology (medical)

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