Minimally invasive evaluation of coronary microvascular function by electron beam computed tomography

S. Mohlenkamp, Lilach O Lerman, Amir Lerman, T. R. Behrenbeck, Zvonimir S Katusic, P. F. Sheedy, E. L. Ritman

Research output: Contribution to journalArticle

57 Citations (Scopus)

Abstract

Background - We previously demonstrated that in vivo electron-beam computed tomography (EBCT)-based indicator-dilution methods provide an estimate of intramyocardial blood volume (BV) and perfusion (F), which relate as BV=aF+b√F, where a characterizes the recruitable (exchange) and b the nonrecruitable (conduit) component of the myocardial microcirculation. In the present study, we compared BV and F with intracoronary Doppler ultrasound-based coronary blood flow (CBF) as a method for detecting and quantifying differential responses of these microvascular components to vasoactive drugs in normal (control) and hypercholesterolemic (HC) pigs. Methods and Results - BV and F values were obtained from contrast-enhanced EBCT studies in 14 HC and 14 control pigs. BV, F, and CBF values were obtained at baseline (intracoronary infusion of saline) and after 5 minutes each of intracoronary infusion of adenosine (100 μg · kg-1 · min-1) and nitroglycerin (40 μg/min). BV and CBF reserves in response to adenosine were attenuated in HC pigs compared with controls (90±36% versus 127±42%, P<0.03, and 485±182% versus 688±160%, P<0.01, respectively). The relationship between BV and F showed consistently lower recruitable BV in HC versus control pigs. Nonrecruitable BV reserve in response to adenosine was attenuated in HC compared with controls (77±20% versus 135±28%, P<0.001). Our findings are consistent with HC-induced impairment of intramyocardial resistance vessel function. Conclusions - EBCT technology allows minimally invasive evaluation of intramyocardial microcirculatory function and permits assessment of microvascular BV distribution in different functional components. This method may be of value in evaluating the coronary microcirculation in pathophysiological states such as hypercholesterolemia.

Original languageEnglish (US)
Pages (from-to)2411-2416
Number of pages6
JournalCirculation
Volume102
Issue number19 SUPPL.
StatePublished - Nov 7 2000

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X Ray Computed Tomography
Blood Volume
Swine
Adenosine
Microcirculation
Doppler Ultrasonography
Nitroglycerin
Hypercholesterolemia
Perfusion
Technology

Keywords

  • Blood volume
  • Hypercholesterolemia
  • Microcirculation
  • Myocardium
  • Ultrasonics

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Mohlenkamp, S., Lerman, L. O., Lerman, A., Behrenbeck, T. R., Katusic, Z. S., Sheedy, P. F., & Ritman, E. L. (2000). Minimally invasive evaluation of coronary microvascular function by electron beam computed tomography. Circulation, 102(19 SUPPL.), 2411-2416.

Minimally invasive evaluation of coronary microvascular function by electron beam computed tomography. / Mohlenkamp, S.; Lerman, Lilach O; Lerman, Amir; Behrenbeck, T. R.; Katusic, Zvonimir S; Sheedy, P. F.; Ritman, E. L.

In: Circulation, Vol. 102, No. 19 SUPPL., 07.11.2000, p. 2411-2416.

Research output: Contribution to journalArticle

Mohlenkamp, S, Lerman, LO, Lerman, A, Behrenbeck, TR, Katusic, ZS, Sheedy, PF & Ritman, EL 2000, 'Minimally invasive evaluation of coronary microvascular function by electron beam computed tomography', Circulation, vol. 102, no. 19 SUPPL., pp. 2411-2416.
Mohlenkamp, S. ; Lerman, Lilach O ; Lerman, Amir ; Behrenbeck, T. R. ; Katusic, Zvonimir S ; Sheedy, P. F. ; Ritman, E. L. / Minimally invasive evaluation of coronary microvascular function by electron beam computed tomography. In: Circulation. 2000 ; Vol. 102, No. 19 SUPPL. pp. 2411-2416.
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abstract = "Background - We previously demonstrated that in vivo electron-beam computed tomography (EBCT)-based indicator-dilution methods provide an estimate of intramyocardial blood volume (BV) and perfusion (F), which relate as BV=aF+b√F, where a characterizes the recruitable (exchange) and b the nonrecruitable (conduit) component of the myocardial microcirculation. In the present study, we compared BV and F with intracoronary Doppler ultrasound-based coronary blood flow (CBF) as a method for detecting and quantifying differential responses of these microvascular components to vasoactive drugs in normal (control) and hypercholesterolemic (HC) pigs. Methods and Results - BV and F values were obtained from contrast-enhanced EBCT studies in 14 HC and 14 control pigs. BV, F, and CBF values were obtained at baseline (intracoronary infusion of saline) and after 5 minutes each of intracoronary infusion of adenosine (100 μg · kg-1 · min-1) and nitroglycerin (40 μg/min). BV and CBF reserves in response to adenosine were attenuated in HC pigs compared with controls (90±36{\%} versus 127±42{\%}, P<0.03, and 485±182{\%} versus 688±160{\%}, P<0.01, respectively). The relationship between BV and F showed consistently lower recruitable BV in HC versus control pigs. Nonrecruitable BV reserve in response to adenosine was attenuated in HC compared with controls (77±20{\%} versus 135±28{\%}, P<0.001). Our findings are consistent with HC-induced impairment of intramyocardial resistance vessel function. Conclusions - EBCT technology allows minimally invasive evaluation of intramyocardial microcirculatory function and permits assessment of microvascular BV distribution in different functional components. This method may be of value in evaluating the coronary microcirculation in pathophysiological states such as hypercholesterolemia.",
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AU - Lerman, Lilach O

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AU - Katusic, Zvonimir S

AU - Sheedy, P. F.

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AB - Background - We previously demonstrated that in vivo electron-beam computed tomography (EBCT)-based indicator-dilution methods provide an estimate of intramyocardial blood volume (BV) and perfusion (F), which relate as BV=aF+b√F, where a characterizes the recruitable (exchange) and b the nonrecruitable (conduit) component of the myocardial microcirculation. In the present study, we compared BV and F with intracoronary Doppler ultrasound-based coronary blood flow (CBF) as a method for detecting and quantifying differential responses of these microvascular components to vasoactive drugs in normal (control) and hypercholesterolemic (HC) pigs. Methods and Results - BV and F values were obtained from contrast-enhanced EBCT studies in 14 HC and 14 control pigs. BV, F, and CBF values were obtained at baseline (intracoronary infusion of saline) and after 5 minutes each of intracoronary infusion of adenosine (100 μg · kg-1 · min-1) and nitroglycerin (40 μg/min). BV and CBF reserves in response to adenosine were attenuated in HC pigs compared with controls (90±36% versus 127±42%, P<0.03, and 485±182% versus 688±160%, P<0.01, respectively). The relationship between BV and F showed consistently lower recruitable BV in HC versus control pigs. Nonrecruitable BV reserve in response to adenosine was attenuated in HC compared with controls (77±20% versus 135±28%, P<0.001). Our findings are consistent with HC-induced impairment of intramyocardial resistance vessel function. Conclusions - EBCT technology allows minimally invasive evaluation of intramyocardial microcirculatory function and permits assessment of microvascular BV distribution in different functional components. This method may be of value in evaluating the coronary microcirculation in pathophysiological states such as hypercholesterolemia.

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