title: Effect of hyperoxia and vitamin C on coronary blood flow in patients with ischemic heart disease.
abstract: Pathological formation of reactive oxygen species within the coronary circulation has been hypothesized to mediate some clinical manifestations of ischemic heart disease (IHD) by interfering with physiological regulation of coronary tone. To determine the degree to which coronary tone responds to acute changes in ambient levels of oxidants and antioxidants in vivo in a clinical setting, we measured the effect of an acute oxidative stress (breathing 100% oxygen) on coronary capacitance artery diameter (quantitative angiography) and blood flow velocity through the coronary microcirculation (intracoronary Doppler ultrasonography) before and after treatment with the antioxidant vitamin C (3-g intravenous infusion) in 12 IHD patients undergoing a clinical coronary interventional procedure. Relative to room air breathing, 100% oxygen breathing promptly reduced coronary blood flow velocity by 20% and increased coronary resistance by 23%, without significantly changing the diameter of capacitance arteries. Vitamin C administration promptly restored coronary flow velocity and resistance to a slightly suprabasal level, and it prevented the reinduction of coronary constriction with rechallenge with 100% oxygen. This suggests that acute oxidative stress produces prompt and substantial changes in coronary resistance and blood flow in a clinical setting in patients with IHD, and it suggests that these changes are mediated by vitamin C-quenchable substances acting on the coronary microcirculation. This observation may have relevance for clinical practice.
authors.affiliation: Div. of Cardiology, Penn State College of Medicine, Hershey, Pennsylvania, USA. patrick.mcnulty@Bassett.org
authors.forename: Patrick H
authors.initials: PH
authors.lastname: McNulty
authors.forename: Bryan J
authors.initials: BJ
authors.lastname: Robertson
authors.forename: Mark A
authors.initials: MA
authors.lastname: Tulli
authors.forename: Joshua
authors.initials: J
authors.lastname: Hess
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Harach
authors.forename: Sofia
authors.initials: S
authors.lastname: Scott
authors.forename: Lawrence I
authors.initials: LI
authors.lastname: Sinoway
mesh_terms: D000368:Aged; D000975:Antioxidants / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D001205:Ascorbic Acid / Q000008:administration & dosage / Q000494:pharmacology* / Q000627:therapeutic use; D001783:Blood Flow Velocity / Q000187:drug effects; D017023:Coronary Angiography; D003326:Coronary Circulation / Q000187:drug effects*; D003331:Coronary Vessels / Q000187:drug effects* / Q000378:metabolism / Q000503:physiopathology; D005260:Female; D006801:Humans; D018496:Hyperoxia / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology*; D007262:Infusions, Intravenous; D017078:Laser-Doppler Flowmetry; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000188:drug therapy / Q000378:metabolism / Q000473:pathology / Q000503:physiopathology*; D018384:Oxidative Stress / Q000187:drug effects*; D014655:Vascular Resistance / Q000187:drug effects
chemical_list: D000975:Antioxidants; D001205:Ascorbic Acid