Measurement of coronary vasomotor function: getting to the heart of the matter in cardiovascular research

Author:

HIRATA Kumiko1,AMUDHA Kadirvelu2,ELINA Raja2,HOZUMI Takeshi3,YOSHIKAWA Junichi3,HOMMA Shunichi1,LANG Chim C.24

Affiliation:

1. Division of Cardiology, Columbia University, New York, U.S.A.

2. Department of Medicine, University of Malaya, Malaysia

3. Department of Cardiology, Osaka City University Medical School, Osaka, Japan

4. Department of Medicine and Therapeutics, Ninewells Hospital and Medical School, Dundee, Scotland, U.K.

Abstract

Measurement of endothelial function in patients has emerged as a useful tool for cardiovascular research. Although no gold standard for the measurement of endothelial function exists, the measurement of flow-mediated dilation in the brachial artery, assessed with Doppler ultrasonography, is the most studied method. However, the assumption that endothelial dysfunction detected in brachial arteries is a manifestation of systemic endothelial dysfunction including the coronary circulation may not be entirely valid. Brachial and myocardial circulations differ in terms of the microvascular architecture, the pattern of blood flow and vascular resistance (e.g. shunt vessels occur in the hand but not in the myocardium), their metabolic regulation, type of receptors that contribute to humoral regulation and the pathways that are activated to induce hyperaemia. In this context, measuring coronary vasomotor function may be more useful than brachial artery measures to predict and assess potential myocardial damage related to limited vascular responsiveness. This review aims to provide an overview of the basic concept of coronary flow reserve and its different modalities of measurement, as well as its utility in cardiovascular research.

Publisher

Portland Press Ltd.

Subject

General Medicine

Reference91 articles.

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