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Am J Physiol Heart Circ Physiol 282: H611-H614, 2002. First published October 18, 2001; doi:10.1152/ajpheart.00797.2001
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Vol. 282, Issue 2, H611-H614, February 2002

Reduced coronary and inotropic reserves with coronary microembolization

Andreas Skyschally1, Rainer Schulz1, Raimund Erbel2, and Gerd Heusch1

1 Abteilungen für Pathophysiologie und 2 Kardiologie, Zentrum für Innere Medizin, Universitätsklinikum Essen, 45122 Essen, Germany

Microembolized myocardium is characterized by perfusion-contraction mismatch with reduced contractile function and unchanged or even elevated blood flow. The present study investigated the consequences of microembolization on coronary and inotropic reserves. In eight anesthetized dogs, left circumflex coronary blood flow (CBF), regional blood flow (RBF), and posterior systolic wall thickening were measured. Repetitive injection of 42-µm microspheres into the left circumflex coronary artery decreased systolic wall thickening by 50% (17.2 ± 2.4% vs. 8.0 ± 1.4%; means ± SD). Coronary reserve was determined by either intracoronary infusion of adenosine (n = 4) or the reactive hyperemia response following 15 s of coronary occlusion (n = 4); inotropic reserve was recruited by intracoronary infusion of dobutamine. The amount of injected microspheres was 158,000 ± 48,000. CBF (45.5 ± 16.5 vs. 47.8 ± 14.4 ml/min) and RBF (1.15 ± 0.18 vs. 1.33 ± 0.39 ml · min-1 · g-1) remained unchanged. Coronary reserve in response to intracoronary infusion of adenosine (410 ± 94% vs. 290 ± 77%; P < 0.05) and reactive hyperemia repayment (360 ± 174% vs. 155 ± 66%; P < 0.05) were blunted after microembolization. Inotropic reserve, i.e., the increment in systolic wall thickening with dobutamine, was decreased from 12.4 ± 3.9% to 8.0 ± 3.3% (P < 0.05). We conclude that coronary microembolization reduces coronary and inotropic reserves.

atherosclerosis; embolism; microcirculation; regional blood flow; regional myocardial function


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