Article

Myocardial microvascular function during acute coronary artery stenosis: effect of hypertension and hypercholesterolaemia.

Division of Nephrology and Hypertension, Department of Internal Medicine, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA.
Cardiovascular research (impact factor: 5.8). 05/2009; 83(2):371-80. DOI:10.1093/cvr/cvp140 pp.371-80
Source: PubMed

ABSTRACT Coronary collateral arteries (CCA) reduce cardiovascular events. We tested the hypothesis that new microvessels that proliferate in early atherosclerosis may be associated with myocardial protection during acute subtotal coronary artery obstruction (CAO).
Acute left anterior descending CAO was induced by a balloon catheter in pigs after 12 weeks of high-cholesterol (HC) diet, renovascular hypertension (HTN), or normal control. Cardiac structure, myocardial perfusion, and functional response to iv adenosine and CAO were studied in vivo using electron beam computed tomography (CT). The intra-myocardial microvessels were subsequently evaluated ex vivo using micro-CT, and myocardial expression of growth factors using immunoblotting. Basal myocardial perfusion and microvascular permeability were similar among the groups, whereas their responses to adenosine were attenuated in HC and HTN. A significant decline in myocardial perfusion in normal pigs during acute CAO was attenuated in HC and abolished in HTN. CAO also elicited an increase in normal anterior wall microvascular permeability (+202 +/- 59%, P < 0.05), which was attenuated in HC and HTN (+55 +/- 9 and +31 +/- 8%, respectively, P < 0.05 vs. normal). Microvascular (<200 microm) spatial density was significantly elevated in HC and HTN, accompanied by increased myocardial growth factor expression.
This study demonstrates that early exposure to the cardiovascular risk factors HC and HTN protects the heart from decreases in myocardial perfusion during acute subtotal CAO. This protective effect is associated with and potentially mediated by pre-emptive development of intra-myocardial microvessels that might serve as recruitable CCA.

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Keywords

acute CAO
 
acute subtotal CAO
 
acute subtotal coronary artery obstruction
 
anterior descending CAO
 
balloon catheter
 
Basal myocardial perfusion
 
Cardiac structure
 
cardiovascular risk factors HC
 
electron beam computed tomography
 
ex vivo
 
functional response
 
growth factors
 
intra-myocardial microvessels
 
microvascular permeability
 
myocardial expression
 
myocardial growth factor expression
 
myocardial perfusion
 
myocardial protection
 
new microvessels
 
protective effect
 

Xiang-Yang Zhu