gms | German Medical Science

27. Wissenschaftlicher Kongress der Deutschen Hochdruckliga

Deutsche Liga zur Bekämpfung des hohen Blutdrucks – Deutsche Hypertonie Gesellschaft e. V.

26. bis 29.11.2003, Bonn

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Endothelium-dependent vasodilation in forearm skin microcirculation is a surrogate for coronary vasomotion in CAD

Die Endothel-abhängige Vasodilatation in der Unterarm-Hautmikrozirkulation ist ein Surrogat für die koronare Vasomotion bei KHK-Patienten

Meeting Abstract (Hypertonie 2003)

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  • presenting/speaker H. Bruck - Universitätsklinikum Essen (Essen, D)
  • C. Naber - Universitätsklinikum Essen (Essen, D)
  • D. Baumgart - Universitätsklinikum Essen (Essen, D)
  • R.F. Schäfers - Universitätsklinikum Essen (Essen, D)
  • R. Erbel - Universitätsklinikum Essen (Essen, D)
  • T. Philipp - Universitätsklinikum Essen (Essen, D)
  • R.R. Wenzel - Universitätsklinikum Essen (Essen, D)

Hypertonie 2003. 27. Wissenschaftlicher Kongress der Deutschen Hochdruckliga. Bonn, 26.-29.11.2003. Düsseldorf, Köln: German Medical Science; 2004. Doc03hochP58

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/hoch2003/03hoch158.shtml

Published: November 11, 2004

© 2004 Bruck et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objectives

In coronary artery disease (CAD) endothelial function may be disturbed in an early phase of the disease; endothelial dysfunction can be quantified by assessing coronary dilatation to acetylcholine (Ach).

The study aimed to investigate whether in patients with CAD endothelium-dependent vasomotion measured invasively by quantitative coronary angiography is related to vasomotion in skin microcirculation.

Methods

7 patients (2 female, 5 male, mean age 54±4 years, BMI 26±2 kg/m2) with CAD underwent invasive coronary angiography and were intracoronary infused with Ach (10-6 to 10-8 mol). Ach-effects were measured by quantitative coronary angiography (in APV) and were correlated with changes in blood flow assessed with double-injection-technique and laser-Doppler flowmetry in the forearm skin microcirculation (in arbitrary perfusion units, PU) after intradermal injection of Ach (10-6 to 10-8 mol) [Fig. 1].

Results

In 6 patients Ach induced a dose-dependent vasodilatation of the coronary artery (delta APV for Ach 10-6: 7,5±2,3; Ach10-7: 0,83±0,8 and Ach10-8: -0,98±1,9) and in skin microcirculation (delta PU: Ach 10-6: 1396±331; Ach10-7: 1232±515 and Ach10-8: 582±358); in 1 patient Ach induced paradox vasoconstriction of the coronary artery and in skin microcirculation. Ach-induced changes in coronary artery perfusion significantly correlated with changes in skin microcirculation perfusion (p=0.04, r2=0,2, see figure). Furthermore, there was a positive correlation between serum LDL-levels with Ach-induced changes (p=0,02; r2=0,68 for the coronary artery and p=0,01; r2=0,76 for skin microcirculation).

Conclusion

In patients with CAD assessment of endothelium-dependent vasodilatation in the forearm skin microcirculation by double-injection technique and laser-Doppler-flowmetry is a minimal invasive test that predicts coronary endothelial function and correlates with serum LDL-cholesterol.