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      Diminished Coronary Reserve in Patients with Biopsy-Proven Inflammatory Infiltrates

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          Abstract

          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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                Author and article information

                Journal
                CRD
                Cardiology
                10.1159/issn.0008-6312
                Cardiology
                S. Karger AG
                0008-6312
                1421-9751
                2003
                November 2003
                21 November 2003
                : 100
                : 3
                : 120-128
                Affiliations
                Departments of aCardiology, Pneumonology and Angiology, and bPathology, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
                Article
                73912 Cardiology 2003;100:120–128
                10.1159/000073912
                14631132
                © 2003 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

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

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