Sympathetic stimulation using the cold pressor test increases coronary collateral flow

de Marchi, Stefano F.; Schwerzmann, Markus; Billinger, Michael; Windecker, Stephan; Meier, Bernhard; Seiler, Christian (2001). Sympathetic stimulation using the cold pressor test increases coronary collateral flow. Swiss medical weekly, 131(23-24), pp. 351-356. EMH Schweizerischer Ärzteverlag

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BACKGROUND Little is known about the vasomotor function of human coronary collateral vessels. The purpose of this study was to examine collateral flow under a strong sympathetic stimulus (cold pressor test, CPT). METHODS In 30 patients (62 +/- 12 years) with coronary artery disease, two subsequent coronary artery occlusions were performed with random CPT during one of them. Two minutes before and during the 1 minute-occlusion, the patient's hand was immerged in ice water. For the calculation of a perfusion pressure-independent collateral flow index (CFI), the aortic (Pao), the central venous (CVP) and the coronary wedge pressure (Poccl) were measured: CFI = (Poccl - CVP)/(Pao - CVP). RESULTS CPT lead to an increase in Pao from 98 +/- 14 to 105 +/- 15 mm Hg (p = 0.002). Without and with CPT, CFI increased during occlusion from 14% +/- 10% to 16% +/- 10% (p = 0.03) and from 17% +/- 9% to 19% +/- 9% (p = 0.006), respectively, relative to normal flow. During CPT, CFI was significantly higher at the beginning as well as at the end of the occlusion compared to identical instants without CPT. CFI at the end of the control occlusion did not differ significantly from the CFI at the beginning of occlusion with CPT. CONCLUSIONS During balloon occlusion, collateral flow increased due to collateral recruitment independent of external sympathetic stimulation. Sympathetic stimulation using CPT additionally augmented collateral flow. The collateral-flow-increasing effect of CPT is comparable to the recruitment effect of the occlusion itself. This may reflect a coronary collateral vasodilation mediated by the sympathetic nervous system.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

de Marchi, Stefano; Schwerzmann, Markus; Billinger, Michael; Windecker, Stephan; Meier, Bernhard and Seiler, Christian

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1424-7860

Publisher:

EMH Schweizerischer Ärzteverlag

Language:

English

Submitter:

Stefano de Marchi

Date Deposited:

04 Apr 2014 00:45

Last Modified:

07 Dec 2014 07:54

PubMed ID:

11486568

BORIS DOI:

10.7892/boris.40268

URI:

https://boris.unibe.ch/id/eprint/40268

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