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Ethanol-induced coronary vasodilation in patients with and without coronary artery disease
R G Cigarroa1, R A Lange, J J Popma
1Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas 75235.
Insights
Intracoronary ethanol administration increases coronary blood flow and reduces vascular resistance. These effects appear to stem from dilation of smaller, intramyocardial vessels, not major coronary arteries.
Area of Science:
- Cardiovascular Physiology
- Pharmacology
Background:
- Ethanol's effects on coronary circulation are not fully understood.
- Previous research has not clarified whether ethanol impacts epicardial arteries or resistance vessels.
Purpose of the Study:
- To investigate the impact of intracoronary ethanol on coronary blood flow and dimensions.
- To differentiate between effects on epicardial coronary arteries and intramyocardial resistance vessels.
Main Methods:
- Coronary sinus blood flow and dimensions were measured in 35 subjects (29 with coronary artery disease, 6 without).
- Subjects received either a control (dextrose in water) or ethanol infusion.
- Hemodynamic parameters and arterial-coronary sinus oxygen content were monitored.
Main Results:
- Ethanol infusion significantly increased coronary sinus blood flow by 27% and decreased coronary vascular resistance by 17%.
- Heart rate-systolic arterial pressure product remained unchanged during ethanol infusion.
- Epicardial coronary arterial dimensions showed no significant change, while arterial-coronary sinus oxygen content difference decreased.
Conclusions:
- Intracoronary ethanol enhances coronary blood flow and reduces resistance.
- The observed effects suggest ethanol primarily dilates intramyocardial resistance vessels rather than epicardial arteries.
Abstract:
To assess the influence of ethanol on coronary arterial blood flow and dimensions, we measured coronary sinus blood flow in 35 subjects (23 men and 12 women, aged 38 to 69 years; (29 with and 6 without coronary artery disease) before and during a 15- to 30-minute intracoronary infusion of (1) 5% dextrose in water (n = 15, controls) or (2) 5% dextrose in water (n = 20). In the controls heart rate, arterial pressure, and coronary sinus blood flow were unchanged. In those receiving ethanol at a rate that produced a concentration in coronary sinus blood of 285 +/- 102 (mean +/- SD) mg/dl, heart rate-systolic arterial pressure product was unchanged; coronary sinus blood flow rose 27 +/- 36%, and coronary vascular resistance fell 17 +/- 22% (p less than 0.05 in comparison to baseline); arterial-coronary sinus oxygen content difference fell (p less than 0.05), and epicardial coronary arterial dimensions were unchanged. Thus intracoronary ethanol increases coronary blood flow and decreases resistance without inducing a change in epicardial coronary dimensions, suggesting that its effect results from dilatation of the intramyocardial resistance vessels.
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