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Articles in PresS, published online ahead of print August 23, 2002
J Appl Physiol, 10.1152/jap.00544.2002
Submitted on June 21, 2002
Accepted on August 20, 2002
1 Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA; Biomedical Engineering, Marquette University, Milwaukee, Wisconsin, USA
2 Biomedical Engineering, Marquette University, Milwaukee, Wisconsin, USA
3 Boston Scientific - Scimed, Maple Grove, Minnesota, USA
4 Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
5 Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA; Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
6 Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA; Pharmacology and Toxicology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA; Biomedical Engineering, Marquette University, Milwaukee, Wisconsin, USA
* To whom correspondence should be addressed. E-mail: pspagel{at}mcw.edu.
Coronary stents improve resting blood flow and flow reserve in the presence of stenoses, but the impact of these devices on fluid dynamics during profound vasodilation is largely unknown. We tested the hypothesis that stent implantation affects adenosine-induced alterations in coronary hemodynamics and wall shear stress in anesthetized dogs (n=6) instrumented for measurement of left anterior descending coronary artery (LAD) blood flow, velocity, diameter, and radius of curvature. Indices of fluid dynamics and shear stress were determined before and after placement of a slotted-tube stent in the absence and presence of an adenosine infusion (1.0 mg/min). Adenosine increased blood flow, Reynolds and Dean numbers (Re and De, respectively), and regional and oscillatory shear stress (
and os, respectively) concomitant with reductions in LAD vascular resistance and segmental compliance before stent implantation. Increases in LAD blood flow, Re, De, and indices of shear stress were observed after stent deployment (P<0.05). Stent implantation reduced LAD segmental compliance to zero and potentiated increases in segmental and coronary vascular resistance during adenosine. Adenosine-induced increases in coronary blood flow and reserve, Re, De, , and os were attenuated after the stent was implanted. The results indicate that stent implantation blunts alterations in fluid dynamics during coronary vasodilation in vivo.
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