Variable response of conductance and resistance coronary arteries to endothelial stimulation in patients with heart failure due to nonischemic dilated cardiomyopathy
Variable response of conductance and resistance coronary arteries to endothelial stimulation in patients with heart failure due to nonischemic dilated cardiomyopathy
复制标题
DOI：
10.1177/1074248406292574
复制
发表时间：
2006-09-01
影响因子：
2.6
通讯作者：
Elkayam, Uri
中科院分区：
文献类型：
--
作者：
Bitar, Fahed;Lerman, Amir;Elkayam, Uri
在特发性扩张型心肌病和解剖学正常的冠状动脉中已经报道了内皮依赖性冠状动脉血管舒张的减弱;然而，数据不足以理解这一发现的发生率和程度。本文观察了25例患者冠状动脉对乙酰胆碱刺激内皮细胞的反应。冠状动脉血流量对乙酰胆碱的反应不同，提示约一半的患者存在冠状动脉内皮功能障碍。异常内皮功能障碍涉及大电导心外膜冠状动脉和小阻力血管。冠状动脉血流对乙酰胆碱的异常内皮反应不能通过人口统计学和血流动力学数据来预测。结论：扩张型心肌病患者冠状动脉内皮功能存在异质性。内皮功能障碍存在于大约一半的病例中，并且涉及阻力以及电导冠状血管。此外，冠状动脉内皮功能不能预测人口统计学和血流动力学参数或左心室射血分数。
Attenuation of endothelial-dependent coronary vasodilation has been reported in idiopathic dilated cardiomyopathy and anatomically normal coronaries; however, data are insufficient for understanding the incidence and extent of this finding. The response of conductance and resistance coronary arteries to endothelial stimulation with acetylcholine was examined in 25 patients. Coronary blood flow had a variable response to acetylcholine and suggested coronary endothelial dysfunction in approximately half of the patients. Abnormal endothelial dysfunction involved the large conductance epicardial coronary arteries and the small resistance vessels. Abnormal endothelial response of coronary blood flow to acetylcholine could not be predicted by demographic and hemodynamic data. Conclusions: Coronary artery endothelial function is heterogeneous in patients with idiopathic dilated cardiomyopathy. Endothelial dysfunction is present in approximately half of the cases and involves both resistance as well as conductance coronary blood vessels. Furthermore, coronary endothelial function cannot be predicted by demographic and hemodynamic parameters or left ventricular ejection fraction.