2000 Fiscal Year Final Research Report Summary
Mechanism of PTCRA-induced injury of the coronary microcircuration
| Project/Area Number |
11670722
|
|---|
| Research Category |
Grant-in-Aid for Scientific Research (C)
|
| Allocation Type | Single-year Grants |
|---|
| Section | 一般 |
|---|
| Research Field |
Circulatory organs internal medicine
|
|---|
| Research Institution | KURUME UNIVERSITY |
|---|
Principal Investigator |
MATSUMOTO Takahiro DEPARTMENT OF INTERNAL MEDICINE III, KURUME UNIVERSITY SCHOOL OF MEDICINE, ASSOCIATE PROFESSOR, 医学部, 助教授 (20219504)
|
|---|
| Co-Investigator(Kenkyū-buntansha) |
IKEDA Hisao DEPARTMENT OF INTERNAL MEDICINE III, KURUME UNIVERSITY SCHOOL OF MEDICINE, ASSOCIATE PROFESSOR, 医学部, 助教授 (50168134)
UENO Takafumi DEPARTMENT OF INTERNAL MEDICINE III, KURUME UNIVERSITY SCHOOL OF MEDICINE, ASSOCIATE PROFESSOR, 医学部, 講師 (90184952)
|
|---|
| Project Period (FY) |
1999 – 2000
|
| Keywords | PTCRA / Coronary microcirculation / ADENOSINE / PIATELET |
|---|
| Research Abstract |
Prolonged chest pain and bradycardia are well known complications during percutaneous transiuminal coronary rotational atherectomy (PTCRA), which limit its usefulness. Adenosine has been implicated in myocardial ischemia-related bradycardia and the perception of anginal pain. However, it is not known whether adenosine is also responsible for chest pain and bradycardia during PTCRA.We assessed the inhibitory effect of aminophylline, an adenosine P1 receptor antagonist, on PTCRA-related prolonged chest pain and bradycardia. Of 20 patients with effort angina who underwent PTCRA, aminophylline (5mg/kg) was administered intravenously before the procedure in 10 patients (group A) or saline in the other 10 patients (group B). Patient characteristics (age, sex, coronary risk factors, presence of previous myocardial Infarction and medications) and the lesion location and morphology were similar between these two groups. PTCRA was successful in all patients and there was no significant difference in the procedure (burr/artery ratio, speed and duration of the ablation) between these two groups. In group A, none of 10 patients had chest pain or bradycardia during PTCRA.However , 5 and 4 of 10 patients in group B had chest pain and profound bradycardia (<50bpm) (p<0.05). The changes of blood pressure and ΣST-elevation (sum of ST segment elevations) on the electrocardiograms during PTCRA were similar between these two groups. Plasma levels of P-selectin in the distal coronary artery were increased after PTCRA in both two groups. In conclusion, aminophylline did not reduce the severity of myocardial ischemia during PTCRA, probably due, in part, to the platelet activation, but indeed reduced PTCRA-related chest pain and bradycardia probably by antagonizing the adenosine P1 receptor. The pretreatment with aminophylline may make PTCRA safer and easier.
|
Research Products
(1 results)
