Diminished coronary reserve in patients with biopsy-proven inflammatory infiltrates.
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.
Klein
Rolf Michael
RM
Department of Cardiology, Pneumonology and Angiology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany. kleinrm@uni-duesseldorf.de
Schwartzkopff
Bodo
B
Gabbert
Helmut Erich
HE
Strauer
Bodo Eckehard
BE
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