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- W1996405909 abstract "Background: Subjects with end-stage renal failure (ESRF) have markedly elevated rates of cardiovascular morbidity and mortality. While the cause of this is likely multifactorial, the effect of chronic kidney disease (CKD) on coronary vascular dynamic function remains poorly understood. Methods: Two groups with only minor coronary artery disease at angiography were evaluated; potential renal transplant recipients (n = 8, 51.9 ± 8.8 years); and control subjects with normal creatinine clearance (>60 ml/min) (n = 12, 53.9 ± 13.9 years). Coronary angiography and Doppler flow wire assessment was performed at baseline and during intracoronary infusion of acetylcholine (Ach), glyceryl trinitrate (GTN) and adenosine. Arterial lumen cross sectional area (CSA) in conjunction with coronary blood flow (CBF) and coronary flow reserve (CFR) were calculated. Results: Following administration of the endothelial dependent vasodilator Ach, no difference was observed between the groups for baseline (80.6 ± 34 vs. 107.9 ± 38, p = 0.11) or peak CBF (146.9 ± 77 vs. 189.7 ± 58, p = 0.21). Maximum change in CBF following Ach was similar between the groups (81.0 ± 68% vs. 89.8 ± 71%, p = 0.79). There was no difference between the groups in endothelium-independent vasodilation following intra-coronary GTN (vessel CSA: 24.0 ± 49% vs. 24.3 ± 26%, p = 0.99). There was, however, a highly significant difference in microvascular function between the CKD and non-CKD cohorts, as measured by CFR (1.9 ± 0.4 vs. 3.0 ± 1.1, p = 0.01). Conclusion: This study demonstrates clear impairment of coronary endothelial-independent microvascular dilatation in subjects with ESRF. Such findings have important implications for the promotion of inducible myocardial ischaemia in advanced CKD, even in the absence of significant epicardial coronary stenoses." @default.
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- W1996405909 date "2012-01-01" @default.
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- W1996405909 title "Impaired Coronary Microvascular Function in End-stage Renal Failure" @default.
- W1996405909 doi "https://doi.org/10.1016/j.hlc.2012.05.109" @default.
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