title: Nitroglycerin-induced heterogeneous subendocardial myocardial blood flow observed by cardioscopy in patients with coronary artery disease.
abstract: It is controversial as to whether or not nitroglycerin (NTG) increases subendocardial myocardial blood flow (SMBF), and if it does, whether arterial or venous blood flow is increased in patients with coronary artery disease. This study was performed to examine NTG-induced changes in SMBF.Changes in SMBF induced by NTG (200 µg, i.v.) were examined by cardioscopy in 58 left ventricular wall segments of 58 patients with coronary artery disease. NTG-induced red and purple endocardial colors were defined as increased arterial and venous SMBF, respectively. Endocardial color before NTG administration was classified into brown, light brown, pale and white. Endomyocardial biopsy of the observed portion and (201)Tl scintigraphy were performed in 40 of these patients immediately after cardioscopy and several days after cardioscopy, respectively.Upon administration of NTG, SMBF increased in 48 of 58 wall segments; arterial SMBF in 34 and venous SMBF in 12 wall segments; arterial SMBF  in all 24 brown to light brown segments; venous SMBF, arterial SMBF and no change in 12, 10 and 5 of pale segments, respectively; and no change in all 10 white wall segments. (201)Tl-scintigraphy and endomyocardial biopsy revealed that brown, light brown, pale and white endocardial color represented no ischemia, mild ischemia, severe ischemia and fibrosis, respectively.NTG caused an increase in either arterial or venous SMBF depending on control endocardial color, wall motion and severity of coronary stenosis.
authors.affiliation: Department of Cardiology, Toho University Ohmori Hospital, Tokyo, Japan.
authors.forename: Yasuto
authors.initials: Y
authors.lastname: Uchida
authors.forename: Yasumi
authors.initials: Y
authors.lastname: Uchida
authors.forename: Yuko
authors.initials: Y
authors.lastname: Maezawa
authors.forename: Yoshiro
authors.initials: Y
authors.lastname: Maezawa
authors.forename: Takeshi
authors.initials: T
authors.lastname: Sakurai
authors.forename: Masahito
authors.initials: M
authors.lastname: Kanai
authors.forename: Seiichiro
authors.initials: S
authors.lastname: Shirai
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Tabata
mesh_terms: D001706:Biopsy; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000503:physiopathology*; D003326:Coronary Circulation / Q000187:drug effects*; D003331:Coronary Vessels / Q000187:drug effects* / Q000503:physiopathology; D004699:Endocardium; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000473:pathology; D005996:Nitroglycerin; D012039:Regional Blood Flow / Q000187:drug effects*; D012720:Severity of Illness Index; D014664:Vasodilation / Q000187:drug effects*; D014665:Vasodilator Agents
chemical_list: D014665:Vasodilator Agents; D005996:Nitroglycerin