Effect of nitroglycerin and nicorandil on regional poststenotic quantitative coronary blood flow in coronary artery disease: A combined digital quantitative angiographic and intracoronary Doppler study
Pk. Haager et al., Effect of nitroglycerin and nicorandil on regional poststenotic quantitative coronary blood flow in coronary artery disease: A combined digital quantitative angiographic and intracoronary Doppler study, J CARDIO PH, 33(1), 1999, pp. 126-134
Citations number
44
Categorie Soggetti
Cardiovascular & Respiratory Systems","Cardiovascular & Hematology Research
Little information is available concerning the effects of nitrates and pota
ssium channel openers on local poststenotic blood flow in coronary artery d
isease (CAD). Combined quantitative digital angiography (QCA) and intracoro
nary Doppler (IVADO) velocity measurements were used to determine changes i
n absolute poststenotic blood flow after intracoronary injection of 0.2 mg
nitroglycerin and 0.5 mg nicorandil. Quantitative blood now (QBF) was calcu
lated from average peak-flow velocity (APV) and angiographic cross-sectiona
l area (CSA): QBF (ml/min) = CSA x APV x 0.5. In group 1 (n = 9), 0.5 mg ni
corandil i.c. was identified as optimal to achieve maximal vasodilatation.
In patients with CAD (group II, n = 12), i.c. injection of 0.5 mg nicorandi
l induced a significant increase in poststenotic CSA (+38%) and QBF (+50%).
In contrast, 0.2 mg nitroglycerin (group III, n = 12) increases poststenot
ic CSA (+38%) without a significant change in QBF (+23%). Additional applic
ation of nicorandil in these patients induced further significant increases
in CSA (+55%) and QBF (+48%) compared with baseline. There were no signifi
cant changes in stenosis area, Poststenotic blood flow can be increased by
nicorandil after application of nitroglycerin. This effect is most likely m
ediated by the potassium channel-opening effect of nicorandil, Combined use
of QCA and IVADO is a unique approach to measure local poststenotic QBF in
patients with CAD.