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      Diminished Coronary Reserve in Patients with Biopsy-Proven Inflammatory Infiltrates


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          Objective: We tested the hypothesis that patients with biopsy-proven inflammatory infiltrates have an impaired vasodilator capacity of the coronary microvasculation. Methods: In 80 patients with clinically suspected inflammatory heart disease, coronary regulation was assessed with the argon method (1) at rest and maximal coronary flow (V<sub>cor</sub>/V<sub>max</sub>) and (2) at rest and minimal coronary resistance (R<sub>cor</sub>/R<sub>min</sub>) both before and after dipyridamole (0.5 mg/kg body weight) treatment. Results: Compared to patients without evidence of myocardial inflammation in endomyocardial biopsy (n = 51) but similar demographic characteristics, patients with biopsy-proven inflammatory infiltrates (n = 29) showed significantly reduced maximal coronary flow (286 ± 122 vs. 189 ± 78 ml/min × 100 g; p = 0.001) and minimal coronary resistance was increased (0.40 ± 0.17 vs. 0.60 ± 0.27 mm Hg × min × 100 g/ml<sup>–1</sup>, p = 0.001). The coronary reserve in patients with inflammatory infiltrates was markedly reduced (3.5 ± 1.1 to 2.4 ± 0.81, p = 0.001). Conclusion: Patients with biopsy-proven inflammatory infiltrates have a diminished coronary reserve due to reduced coronary vasodilator capacity. This may be due to the involvement of the intramural coronary vasculature in inflammatory heart disease.

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          Most cited references 6

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          Right ventricular endomyocardial biopsy using percutaneous right internal jugular approach proved a safe and easily performed technique in more than 1,300 procedures. Adequate tissue was obtained in more than 98 percent of patients and morbidity rate was remarkably low. Other approaches to the right ventricle may be used, but retrograde left ventricular endomyocardial biopsy appears to be the safest and most reliable alternative to transjugular right ventricular biopsy. The safety and success of the techniques for right and left heart biopsy described depend on meticulous attention to methodologic detail.
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              Pathology of small coronary arteries


                Author and article information

                S. Karger AG
                November 2003
                21 November 2003
                : 100
                : 3
                : 120-128
                Departments of aCardiology, Pneumonology and Angiology, and bPathology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
                73912 Cardiology 2003;100:120–128
                © 2003 S. Karger AG, Basel

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                Page count
                Figures: 6, Tables: 2, References: 38, Pages: 9
                General Cardiology


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