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Updated: Aug 30, 2026
Evaluation of Coronary Flow Reserve After Myocardial Ischemia Reperfusion in Rats
Published on: June 28, 2019
Coronary flow reserve is impaired early after cardiac transplantation
Insights
Coronary flow reserve (CFR) is impaired early after cardiac transplantation, potentially contributing to graft dysfunction. This early impairment in microcirculation function may precede the development of coronary occlusive disease.
Area of Science:
- Cardiology
- Transplantation Medicine
- Vascular Biology
Background:
- The first year post-cardiac transplantation has the highest mortality rate.
- The status of coronary microcirculation in the early post-transplant period remains unassessed.
- Coronary occlusive disease (COD) is a significant long-term complication after cardiac transplantation.
Purpose of the Study:
- To investigate the hypothesis that coronary flow reserve (CFR) is impaired in the early postoperative period following cardiac transplantation.
- To assess early changes in coronary microcirculation function after cardiac transplantation.
Main Methods:
- Utilized a 3F intracoronary Doppler flow probe in the left anterior descending coronary artery.
- Assessed maximal coronary flow using the non-endothelial-dependent vasodilator papaverine.
- Compared CFR between patients studied 3 months post-operation (Group A) and those studied 4 years post-operation (Group B).
Main Results:
- Coronary flow reserve (CFR) was significantly impaired in early post-transplant patients (Group A) compared to late post-transplant patients (Group B) (3.3 vs. 4.2, P < 0.01).
- Impairment was attributed to higher resting flow and lower peak flow in the early group.
- No significant differences were observed in other clinical parameters between groups.
Conclusions:
- Coronary microcirculation function, specifically CFR, is markedly impaired in the early postoperative period after cardiac transplantation.
- This early impairment may contribute to early graft dysfunction and potentially lead to the development of coronary occlusive disease (COD).
- Changes in vascular smooth muscle function are implicated in the observed microcirculatory dysfunction.
Abstract:
The highest mortality rate after cardiac transplantation, at present, occurs within the first year after cardiac transplantation. The state of the coronary microcirculation soon after cardiac transplantation has not been previously assessed. We investigated the hypothesis that coronary flow reserve (CFR) is impaired in the early postoperative period after cardiac transplantation. A 3F intracoronary Doppler flow probe was inserted into the left anterior descending coronary artery and maximal coronary flow was assessed using the non-endothelial-dependent vasodilator papaverine. We compared two groups of patients: group A--13 patients studied 3 months after operation; and group B--25 patients studied at a median of 4 years after operation (range 2-8 years) without coronary occlusive disease (COD). CFR was defined as the quotient of maximum hyperaemic to resting velocity (vel). CFR was markedly impaired in group A patients compared with group B (3.3 SEM 0.3 versus 4.2 SEM 0.2, P < 0.01). No significant differences between mean resting or peak velocities, original diagnosis, age, active rejection, blood pressure, lipid levels, ischaemic time, cyclosporin levels or cytomegalovirus (CMV) status were noted. Responses to papaverine in resistance coronary vessels are impaired in the early postoperative period after cardiac transplantation. This is caused by a combination of higher resting flow and lower peak flow in the early group. This impairment of function in the coronary microcirculation may contribute to early graft dysfunction and reflect changes in vascular smooth muscle function leading to the development of COD.
