Tom Crake

Effect of inhibition of nitric oxide synthesis on epicardial coronary artery caliber and coronary blood flow in humans.

BackgroundNG Monomethyl-L-arginine (L-NMMA), a specific inhibitor of nitric oxide synthesis, was used to determine the effects of inhibition of nitric oxide synthesis in the human coronary circulation. Methods and ResultsTwelve patients (mean age, 52

Absence of myocardial dysfunction during stress in patients with syndrome X

2 years) with normal epicardial coronary arteries were studied. The surface ECG, systemic blood pressure, and coronary venous oxygen saturation (coronary Svo2), an index of coronary blood flow, were monitored continuously. Coronary artery diameter was measured by quantitative arteriography. L-NMMA was given as intracoronary infusions at 2 mLlmin via the diagnostic arteriography catheter. In two patients, low doses (0.01 to 5 gmol/min) of L-NMMA were infused into the nondominant right coronary artery. There was no evidence of ischemia in these patients, who were not included in the final analysis. In 10 patients, higher doses ofL-NMMA (4, 10, and 25

Percutaneous catheter fragmentation and distal dispersion of proximal pulmonary embolus

μmol/min, each for 5 minutes) were infused into the left coronary artery. In six patients, incremental doses of acetylcholine were infused (1, 10, and 100 nmol/min, each for 3 minutes) before and after the L-NMMA infusion. Finally, in all patients, sodium nitroprusside, a nitric oxide donor, was infused. No patient developed myocardial ischemia. The heart rate and systemic blood pressure remained unchanged throughout the infusions. L-NMMA (25 Atmol/min), compared with the control saline infusion, caused a significant reduction in distal (-5.9

IMPORTANCE OF "RECIPROCAL" ELECTROCARDIOGRAPHIC CHANGES DURING OCCLUSION OF LEFT ANTERIOR DESCENDING CORONARY ARTERY: Studies during Percutaneous Transluminal Coronary Angioplasty

2.1%, p=0.021) but not proximal left anterior descending coronary artery (LAD) diameter and a fall in coronary Svo2 from 37.5

Variability of coronary blood flow reserve assessed by Doppler catheter after successful thrombolysis in patients with acute myocardial infarction

2.8% to 34.3

Left ventricular hypercontractility and ST segment depression in patients with syndrome X

2.8% (P=0.019). Sodium nitroprusside dilated the proximal (17.8

Response of the pulmonary circulation to acetylcholine, calcitonin gene-related peptide, substance P and oral nicardipine in patients with primary pulmonary hypertension

6.9%o, P=0.033) and distal (24.5

Inhibition of nitric oxide synthesis in human epicardial coronary arteries and stenoses in relation to serum lipid level.

6.5%, P=0.006) LAD and increased the coronary Svo2 to 61.6

Platelet and Thrombin Activity Following Cardiac Catheterization Despite Treatment with Aspirin.

5.0%o (p=0.0002). Acetylcholine caused significant dilatation of the distal (13.8

Altered resistive vessel function after coronary angioplasty is not due to reduced production of nitric oxide

5.4%, P=0.049) but not proximal LAD and a significant increase in coronary Svo2 from 36.5