Circulation, Vol 88, 77-81, Copyright © 1993 by American Heart Association
K Egashira, T Inou, Y Hirooka, H Kai, M Sugimachi, S Suzuki, T Kuga, Y Urabe and A Takeshita
BACKGROUND. It has been suggested that endothelium-related vasomotion is
important in the control of coronary circulation. Our goal was to determine
if endothelium-dependent dilation of the coronary vasculature was altered
with aging in 18 patients with atypical chest pain (age, 23- 70 years) who
had angiographically normal coronary arteries and no coronary risk factors.
METHODS AND RESULTS. We infused an endothelium- dependent vasodilator
acetylcholine (1, 3, 10, and 30 micrograms/min) and an
endothelium-independent vasodilator papaverine (10 mg) into the left
coronary artery. The large coronary diameter was assessed by arteriography,
and the increase in coronary blood flow was measured using the
intracoronary Doppler catheter technique. Acetylcholine increased coronary
blood flow in a dose-dependent manner with no changes in arterial pressure
and heart rate. The maximum increase in coronary blood flow evoked by
acetylcholine varied widely among patients (increase in coronary blood flow
ranged from 200% to 560%) and was correlated significantly with aging (r =
-.86, P < .001), whereas the peak coronary blood flow response to
papaverine was affected slightly by aging (r = -.44, P = .07). The percent
increase in blood flow response to acetylcholine to the response to
papaverine correlated with aging (r = -.87, P < .001). The slope of the
coronary blood flow response to acetylcholine also correlated significantly
with aging. The large epicardial coronary artery response to the low doses
of acetylcholine (< or = 10 micrograms/min) correlated inversely with
aging. CONCLUSIONS. The results of this study suggest that endothelium-
dependent dilation of coronary arteries evoked by acetylcholine may be
decreased with aging in humans.
ARTICLES
Effects of age on endothelium-dependent vasodilation of resistance coronary artery by acetylcholine in humans
Research Institute of Angiocardiology and Cardiovascular Clinic, Kyushu University School of Medicine, Fukuoka, Japan.
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