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Published on: April 13, 2015
Decreased aortic compliance aggravates subendocardial ischaemia in dogs with stenosed coronary artery
H Watanabe1, S Ohtsuka, M Kakihana
1Department of Internal Medicine, University of Tsukuba, Ibaraki, Japan.
Insights
Decreased aortic compliance worsens outcomes in coronary artery disease patients, especially during increased heart workload. This study in dogs shows reduced oxygen in ischemic heart tissue when aortic compliance is low.
Area of Science:
- Cardiovascular Physiology
- Arteriosclerosis Research
- Myocardial Ischemia
Background:
- Arteriosclerosis commonly reduces aortic compliance in patients with coronary artery disease (CAD).
- The impact of diminished aortic compliance on the compromised myocardium in CAD remains incompletely understood.
Purpose of the Study:
- To investigate how reduced aortic compliance affects coronary artery disease.
- To elucidate the physiological consequences of decreased aortic elasticity on myocardial oxygenation and function.
Main Methods:
- A canine model with induced coronary artery stenosis was utilized.
- Aortic compliance was experimentally reduced by thoracic aorta banding.
- Hemodynamics, myocardial segment length, ECG, and tissue PO2 were measured under varying conditions.
Main Results:
- Aortic banding increased pulse pressure but did not alter other hemodynamic variables.
- During pacing, reduced aortic compliance led to lower subendocardial PO2 and higher subepicardial PO2.
- ST elevation and reduced myocardial shortening were observed with aortic banding during pacing.
Conclusions:
- Decreased aortic compliance exacerbates myocardial ischemia in the setting of coronary artery stenosis.
- Increased cardiac workload, coupled with low aortic compliance, significantly compromises ischemic heart tissue.
Objectives:
The existence of decreased aortic compliance due to arteriosclerosis has been documented in patients with coronary artery disease. The aim of this study was to investigate the effects of decreased aortic compliance on coronary artery disease.
Methods:
To simulate coronary artery disease, a fixed stenosis was made in the left circumflex coronary artery in dogs. Ten anaesthetised open chest dogs were used. Aortic compliance was decreased by banding the thoracic aorta with adjustable plastic rings. The level of coronary stenosis was adjusted to reduce the baseline flow by no more than 10% but enough to eliminate reactive hyperaemia induced by a 10 s occlusion. Measurements of haemodynamics, regional myocardial segment length, subendocardial ECG, and myocardial tissue PO2 were performed at five stages (initial control stage, rest and pacing stages without aortic banding, and rest and pacing stages with the aortic banding).
Results:
Haemodynamic variables were not changed at any stage, except for increased pulse pressure secondary to the aortic banding. During pacing with aortic banding, subendocardial PO2 (Endo) levels were decreased, and subepicardial PO2 (Epi) levels were increased, compared to those without the aortic banding [Endo: 43.2(SD 9.8) v 36.8(10.0) mm Hg, p < 0.05; Epi: 34.0(11.5) v 44.4(7.9) mm Hg, p < 0.05]. ST elevation on the subendocardial ECG was greater, and myocardial segment shortening was less with the aortic bandage during pacing.
Conclusions:
When the work of the heart is increased, a decrease in aortic compliance tends to compromise ischaemic myocardium further in the presence of an induced stenosis of a major coronary artery.
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