The effect of acute hypoxemia on coronary arterial dimensions in patients with coronary artery disease.
OBJECTIVE
To assess the influence of acute hypoxemia on the dimensions of diseased and nondiseased coronary arterial segments in humans.


METHODS
In 18 subjects (age 53 +/- 8 years) with known or suspected coronary artery disease, quantitative coronary angiography was performed before and after being randomly assigned to breathing (1) an inspired oxygen concentration (fraction of inspired oxygen, FIO2) of 21% (room air, RA) for 20 min (n = 4, controls) or (2) an FIO2 of 15 and 10% for 10 min each (corresponding to altitudes of 2,500 and 5,500 m, respectively; n = 14).


RESULTS
In the control subjects, no hemodynamic, oximetric or angiographic variable changed. In the 14 study subjects, the arterial partial pressure of oxygen averaged 85 +/- 13 mm Hg on RA, 65 +/- 15 mm Hg on 15% FIO2 and 44 +/- 13 mm Hg on 10% FIO2. Average arterial segment diameter was 2.52 +/- 0.63 mm on RA, 2.55 +/- 0.62 mm on 15% FIO2 (not significant vs. RA) and 2.66 +/- 0.66 mm on 10% FIO2 (p < 0.001 vs. RA). The increase in coronary arterial diameter with 10% FIO2 occurred only in normal segments (2.74 +/- 0.64 vs. 2.97 +/- 0.64 mm; p < 0.001), but not in diseased segments (2.34 +/- 0.57 vs. 2.38 +/- 0.55 mm; not significant).


CONCLUSIONS
In humans, severe hypoxemia induces vasodilation of angiographically normal coronary arterial segments, whereas it causes no change in diseased segments.
Arbab-Zadeh
Armin
A
Cardiology Division, Johns Hopkins University, 600 N. Wolfe St/Blalock 524, Baltimore, MD 21287-0409, USA. ArminZadeh@jhu.edu
Levine
Benjamin D
BD
Trost
Jeffrey C
JC
Lange
Richard A
RA
Keeley
Ellen C
EC
Hillis
L David
LD
Cigarroa
Joaquin E
JE
D000208:Acute Disease; D006328:Cardiac Catheterization; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000503:physiopathology; D003326:Coronary Circulation / Q000187:drug effects / Q000502:physiology*; D005260:Female; D006801:Humans; D000860:Hypoxia / Q000000981:diagnostic imaging* / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010092:Oximetry; D010100:Oxygen / Q000008:administration & dosage* / Q000097:blood; D012720:Severity of Illness Index; D014664:Vasodilation / Q000187:drug effects / Q000502:physiology*
D010100:Oxygen