Mechanism of hyperaemia induced by saline infusion during coronary thermodilution: Animal experimentation - 25/12/18
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Résumé |
Introduction |
Absolute coronary blood flow and resistance can be measured by thermodilution with a dedicated catheter (RayFlow, HexaCath, Paris, France).
Purpose |
The infusion of saline (15–25mL/min) through the RayFlow Catheter induces maximal hyperaemia. We aimed to explore the mechanisms of this hyperemic response.
Methods |
In 19 domestic swines, instrumented with quantitative Doppler coronary blood flow (CBF) rings on the left artery descending (LAD) and circumflex (LCx) coronary arteries, saline was infused through a RayFlow catheter in the proximal part of the artery to induce hyperemia. The latter was compared to the hyperemic response to a transient coronary occlusion. The possible mechanisms of saline-induced hyperemia were explored under various experimental conditions:
– at different infusion rates;
– infusion through an end-hole;
– infusion at body temperature;
– infusion after inhibition of the endothelial function by (L-arginine methyl ester) L-NAME, by endothelial destruction, or by the placement of a stent;
– vibrations as induced by the use of a Rotablator.
Results |
Compared to hyperaemia induced after coronary occlusion we confirmed that that maximal hyperaemia was elicited by saline at room temperature infused through the side holes at a rate ≥15mL/min without any signs of myocardial ischemia. This response persisted with saline at body-temperature but could not be obtained when saline was infused through an end-hole. A maximal hyperaemic response also occurred after L-NAME (n=10), after balloon de-endothelialisation (n=8), after stent implantation (n=5). Rotablation also induces maximal hyperaemia (n=4) (Figure 1).
Conclusions |
These data confirm that maximal hyperemia is induced by the infusion of saline at room temperature (≥15mL/min) through the side-holes of the RayFlow catheter. This phenomenon is not induced by ischemia and does not depend on the endothelial integrity but might relate to vibrations of the epicardial wall.
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Vol 11 - N° 1
P. 104-105 - janvier 2019 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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