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Saline-Induced Coronary Hyperemia.

Saline-Induced Coronary Hyperemia.

Authors :
De Bruyne, Bernard
Adjedj, Julien
Xaplanteris, Panagiotis
Ferrara, Angela
Yujing Mo
Penicka, Martin
Floré, Vincent
Pellicano, Mariano
Toth, Gabor
Barbato, Emanuele
Duncker, Dirk J.
Pijls, Nico H. J.
Source :
Circulation: Cardiovascular Interventions; Apr2017, Vol. 10 Issue 4, p1-8, 8p
Publication Year :
2017

Abstract

Background--During thermodilution-based assessment of volumetric coronary blood flow, we observed that intracoronary infusion of saline increased coronary flow. This study aims to quantify the extent and unravel the mechanisms of salineinduced hyperemia. Methods and Results--Thirty-three patients were studied; in 24 patients, intracoronary Doppler flow velocity measurements were performed at rest, after intracoronary adenosine, and during increasing infusion rates of saline at room temperature through a dedicated catheter with 4 lateral side holes. In 9 patients, global longitudinal strain and flow propagation velocity were assessed by transthoracic echocardiography during a prolonged intracoronary saline infusion. Taking adenosineinduced maximal hyperemia as reference, intracoronary infusion of saline at rates of 5, 10, 15, and 20 mL/min induced 6%, 46%, 111%, and 112% of maximal hyperemia, respectively. There was a close agreement of maximal saline- and adenosineinduced coronary flow reserve (intraclass correlation coefficient, 0.922; P<0.001). The same infusion rates given through 1 end hole (n=6) or in the contralateral artery (n=6) did not induce a significant increase in flow velocity. Intracoronary saline given on top of an intravenous infusion of adenosine did not further increase flow. Intracoronary saline infusion did not affect blood pressure, systolic, or diastolic left ventricular function. Heart rate decreased by 15% during saline infusion (P=0.021). Conclusions--Intracoronary infusion of saline at room temperature through a dedicated catheter for coronary thermodilution induces steady-state maximal hyperemia at a flow rate ≥15 mL/min. These findings open new possibilities to measure maximal absolute coronary blood flow and minimal microcirculatory resistance. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
19417640
Volume :
10
Issue :
4
Database :
Supplemental Index
Journal :
Circulation: Cardiovascular Interventions
Publication Type :
Academic Journal
Accession number :
122573920
Full Text :
https://doi.org/10.1161/CIRCINTERVENTIONS.116.004719