title: Diminished coronary reserve in patients with biopsy-proven inflammatory infiltrates.
abstract: OBJECTIVE
  We tested the hypothesis that patients with biopsy-proven inflammatory infiltrates have an impaired vasodilator capacity of the coronary microvasculation.
  
  
  METHODS
  In 80 patients with clinically suspected inflammatory heart disease, coronary regulation was assessed with the argon method (1) at rest and maximal coronary flow (V(cor)/V(max)) and (2) at rest and minimal coronary resistance (R(cor)/R(min)) both before and after dipyridamole (0.5 mg/kg body weight) treatment.
  
  
  RESULTS
  Compared to patients without evidence of myocardial inflammation in endomyocardial biopsy (n = 51) but similar demographic characteristics, patients with biopsy-proven inflammatory infiltrates (n = 29) showed significantly reduced maximal coronary flow (286 +/- 122 vs. 189 +/- 78 ml/min x 100 g; p = 0.001) and minimal coronary resistance was increased (0.40 +/- 0.17 vs. 0.60 +/- 0.27 mm Hg x min x 100 g/ml(-1), p = 0.001). The coronary reserve in patients with inflammatory infiltrates was markedly reduced (3.5 +/- 1.1 to 2.4 +/- 0.81, p = 0.001).
  
  
  CONCLUSIONS
  Patients with biopsy-proven inflammatory infiltrates have a diminished coronary reserve due to reduced coronary vasodilator capacity. This may be due to the involvement of the intramural coronary vasculature in inflammatory heart disease.
authors: Department of Cardiology, Pneumonology and Angiology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany. kleinrm@uni-duesseldorf.de
authors: Rolf Michael
authors: RM
authors: Klein
authors: Bodo
authors: B
authors: Schwartzkopff
authors: Helmut Erich
authors: HE
authors: Gabbert
authors: Bodo Eckehard
authors: BE
authors: Strauer
mesh_terms: D000328:Adult; D001707:Biopsy, Needle; D001783:Blood Flow Velocity; D002302:Cardiac Output; D015331:Cohort Studies; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000502:physiology*; D003327:Coronary Disease / Q000150:complications / Q000000981:diagnostic imaging / Q000473:pathology*; D004452:Echocardiography; D005260:Female; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000150:complications / Q000000981:diagnostic imaging; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D009205:Myocarditis / Q000150:complications / Q000473:pathology*; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014655:Vascular Resistance