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Articles in PresS, published online ahead of print October 16, 2001
Am J Physiol Heart Circ Physiol, 10.1152/ajpheart.00797.2001
Submitted on September 7, 2001
Accepted on October 12, 2001
1 Pathophysiology, University of Essen Medical School, Essen, Germany
2 Cardiology, University of Essen Medical School, Essen, Germany
* To whom correspondence should be addressed. E-mail: gerd.heusch{at}uni-essen.de.
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 8 anesthetized dogs left circumflex coronary blood flow (CBF), regional blood flow (RBF), and posterior systolic wall thickening were measured. Repetitive injection of 42µm microspheres into the left circumflex coronary artery decreased systolic wall thickening by 50% (17.2±2.4% vs. 8.0±1.4%;mean±SD). Coronary reserve was determined by either i.c. infusion of adenosine (n=4) or the reactive hyperemia response following 15s coronary occlusion (n=4); inotropic reserve was recruited by i.c. infusion of dobutamine. The amount of injected microspheres was 158,000±48,000. CBF (45.5±16.5 vs. 47.8±14.4ml/min) and RBF (1.15±0.18 vs. 1.33±0.39ml/min/g) remained unchanged. Coronary reserve in response to i.c. 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.
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