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Determinants of myocardial blood flow response to cold pressor testing and pharmacologic vasodilation in healthy humans

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

Response of myocardial blood flow (MBF) to sympathetic stimulation with cold is modulated by endothelium-related factors and is typically altered in the presence of coronary risk factors. Determinants of flow response to cold pressor testing (CPT) in normal volunteers at low risk for CAD remain less well defined, especially relative to baseline conditions such as hemodynamics and MBF, plasma substrate and lipid levels, and total pharmacologically stimulated vasodilator capacity.

Methods

In 50 normal volunteers (42±13 years; 31 women) without coronary risk factors, insulin resistance, or family history of diabetes/premature CAD, MBF was measured with 13N-ammonia and PET at baseline, during CPT, and during pharmacologic hyperemia.

Results

Sympathetic stimulation with CPT raised heart rate and blood pressure and thus MBF (ΔMBF=0.23±0.09 ml/min/g). MBF response, defined in absolute flow units as the difference between CPT and baseline, was independent of age, gender, heart rate, and blood pressure and rate–pressure product (RPP) at baseline as well as plasma substrate and lipid levels with the exception of an association with HDL cholesterol (ρ=0.40, p=0.005) but depended on the change in RPP from rest (ρ=0.33, p=0.019). Finally, changes in coronary vascular resistance in response to CPT were associated with changes in pharmacologic vasodilation (ρ=0.56, p<0.0001).

Conclusion

MBF response to sympathetic stimulation with cold (NO-mediated endothelium-dependent vasomotion), reflecting the functional state of the coronary endothelium, was independent of gender, age, and resting heart conditions. It was modulated by HDL cholesterol levels, even in healthy volunteers, and also related to pharmacologically stimulated vasodilator capacity at the coronary vascular resistance level.

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Acknowledgements

This work was supported by Research Grant #HL 33177, National Heart, Lung and Blood Institute, Bethesda, MD. The authors are greatly indebted to the Medical Cyclotron and PET Imaging staff for producing the radioisotopes and assisting in the studies. They also would like to thank Ms. Ashley Denault and Victoria Bender for secretarial assistance.

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Authors and Affiliations

  1. Department of Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, B2-085J CHS, 10833 Le Conte Ave, Box 956948, Los Angeles, CA, 90095-6948, USA

    John O. Prior, Thomas H. Schindler, Alvaro D. Facta, Miguel Hernandez-Pampaloni, Roxana Campisi, Magnus Dahlbom & Heinrich R. Schelbert

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  1. John O. Prior
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  2. Thomas H. Schindler
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  3. Alvaro D. Facta
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  7. Heinrich R. Schelbert
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Correspondence to Heinrich R. Schelbert.

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Prior, J.O., Schindler, T.H., Facta, A.D. et al. Determinants of myocardial blood flow response to cold pressor testing and pharmacologic vasodilation in healthy humans. Eur J Nucl Med Mol Imaging 34, 20–27 (2007). https://doi.org/10.1007/s00259-006-0193-4

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  • DOI: https://doi.org/10.1007/s00259-006-0193-4

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