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

Kumiko Hirata, Kadirvelu Amudha, Raja Elina, Takeshi Hozumi, Junichi Yoshikawa, Shunichi Homma, Chim C. Lang

Research output: Contribution to journalReview ArticleResearchpeer-review

40 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)449-460
Number of pages12
JournalClinical Science
Volume107
Issue number5
DOIs
Publication statusPublished - Nov 2004
Externally publishedYes

Keywords

  • Coronary flow reserve
  • Coronary microcirculation
  • Echocardiography
  • Endothelial dysfunction
  • Vasomotor function

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