Circulation, Vol 65, 248-255, Copyright © 1982 by American Heart Association
JD Folts, K Gallagher and GG Rowe
In 67 dogs with a 60-80% coronary stenosis produced by an external
constricting plastic ring, blood flow measured with an electromagnetic
flowmeter showed cyclical flow reductions of varying magnitude and
duration, and then an abrupt return to control flow. In 45 dogs, heparin
did not prevent these flow reductions, but ibuprofen (Motrin) or
indomethacin abolished them. With incremental doses of each of these drugs,
the cyclical flow reduction and the platelet function in vitro were
diminished proportionately. In 10 more dogs, during low flow, pinching or
poking the narrowed vessel suddenly restored normal flow. Topical
application of papaverine and nitroglycerin proximal to the stenosis did
not abolish the cyclic flow reduction, although a transient fall in
systemic pressure indicated that they had been absorbed. Seven dogs had the
constricting cylinder and flow probe chronically implanted for 4-6 weeks. A
single oral dose of aspirin, 20 mg/kg, abolished their cyclic flow
reductions for 2-4 days. In five dogs with 70% stenosis in the circumflex
coronary artery, coronary arteriography was performed before coronary flow
reduction and when coronary blood flow was low. This showed that there was
a considerable additional reduction in the size of the mechanically
constricted lumen during spontaneous flow reduction. In one dog, a
nonopacified mass was dislodged from the area of constriction in 67 msec
and this restored the lumen to its control diameter. Similar rapid clearing
was filmed in two more dogs. In no case was vasospasm observed. These
results suggest that obstruction from platelets aggregated in the narrowed
lumen caused the cyclic flow reductions.
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Blood flow reductions in stenosed canine coronary arteries: vasospasm or platelet aggregation?
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