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Sympathetic stimulation using the cold pressor test increases coronary collateral flow.

S F de Marchi1, M Schwerzmann, M Billinger

  • 1Swiss Cardiovascular Center Bern, University Hospital, Bern, Switzerland.

Swiss Medical Weekly
|August 7, 2001
PubMed
Summary
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Coronary collateral flow increases with sympathetic stimulation from the cold pressor test (CPT). This sympathetic stimulation augments collateral flow, comparable to occlusion effects, suggesting vasodilation.

Area of Science:

  • Cardiovascular Physiology
  • Coronary Artery Disease Research
  • Autonomic Nervous System Function

Background:

  • The vasomotor function of human coronary collateral vessels remains poorly understood.
  • Investigating collateral flow under sympathetic stimulation is crucial for understanding coronary artery disease (CAD) pathophysiology.

Purpose of the Study:

  • To examine the impact of sympathetic stimulation, specifically the cold pressor test (CPT), on human coronary collateral vessel flow.
  • To quantify changes in collateral flow index (CFI) during CPT in patients with CAD.

Main Methods:

  • Thirty patients with CAD underwent two coronary artery occlusions, with CPT randomly applied during one occlusion.
  • Collateral flow index (CFI) was calculated using aortic pressure (Pao), central venous pressure (CVP), and coronary wedge pressure (Poccl).

Related Experiment Videos

  • CPT involved immersing the patient's hand in ice water for 1 minute before and during occlusion.

    • Main Results:

    • CPT significantly increased mean aortic pressure (Pao).
    • Collateral flow index (CFI) increased significantly during occlusion, both with and without CPT.
    • CFI was significantly higher during CPT compared to control occlusions at all time points.

    Conclusions:

    • Coronary collateral flow increases due to collateral recruitment during occlusion, independent of external sympathetic stimulation.
    • Sympathetic stimulation via CPT further augments collateral flow, indicating a role for the sympathetic nervous system.
    • The observed coronary collateral vasodilation suggests a mechanism mediated by sympathetic nervous system activation.