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Background: Although Ca ++ antagonists and ACE inhibitors are widely used in the treatment of hypertension, their effect on the elastic properties of the aorta and the mechanisms involved have not been defined.Methods: Serial pressure-diameter loops were obtained in 20 hypertensive pts before and for 20 min after i.v. infusion of diliazem (DL, 10 pts, 0.15 mg/kg over 2 min) or enalaprilat...
Background: Restenosis still remain one of the main limitations of stenting. The purpose of this study was to evaluate the feasibility and efficacy of the autologous vein graft-coated stent (AVGCS) implantation in the coronary arteries of 12 pigs (20-25 Kg).Methods: An autologous vein graft was removed from the right front leg of the animal. It was then cleared from the boundary tissues and it was...
Background: In previous studies we have shown favorable results after autologous vein graft-coated stent (AVGCS) implantation in animals (JACC 1996: 28, 1039-1046). This is the first report of the immediate and long-term results of AVGCS implantation in 51 patients (pts).Methods: A 3-4 cm vein graft was removed from the right cephalic vein. A stent was either covered completely both externally and...
Background: Aorta (Ao), by virtue of its elastic nature, stores energy during cardiac systole which is forwarded to the periphery during diastole. Although the effect of age on Ao elasticity has been addressed, its effect on regional Ao energetics has not been investigated.Methods: We applied a new technique developed in our institution for the in-vivo determination of the pressure-volume relation...
Background: Although implantation of stents is favorably compared to balloon angioplasty, it induces extended vascular injury. In order to address this limitation, autologous arterial- or venous- coated graft stents were implanted in porcine coronary arteries and were compared to uncoated stents.Methods: This study was performed in 15 swines (20-25 kg). A 3-4 cm graft was removed from the porcine...
Background: Aortic elasticity is a major determinant of LV function and coronary flow. We have previously shown, using invasive methodology, that active smoking acutely deteriorates aortic elastic properties (Circulation 1997; 95: 31-38). In the present study we applied a non-invasive, readily available method for the investigation of the effect of smoking on aortic function.Methods: Distensibility...
Background: The proposed mechanism of neurocardiogenic syncope is an intense vagotonic reaction leading to a rather sudden cardioinhibition, and/or vasodilation. The vasodilatory reaction is presumably due to loss of the arterial tone. However, the changes in ao (Ao) wall tone have not been investigated.Methods: We evaluated the Ao wall mechanics during syncope induced by tilting in 5 pts presenting...
Background: Despite the symptomatic improvement of a patient's hemodynamic condition during intraaortic balloon counterpulsation (IABC), the physiologic explanation for its benefit remains controversial. We performed the present study to determine the importance of aortic function in the hemodynamic improvement of the systemic circulation during IABC.Methods: Pressure-diameter (p-d) relation was...
Background: We have previously shown that active smoking deteriorates function the human aorta (Circulation 1997;95:31-38). However, wave reflection along the arterial bed, an important index of arterial stiffening and cardiac afterload, has not been studied during passive smoking.Methods: High-fidelity pressure waveforms of the thoracic aorta were obtained before and for 20 min. after the initiation...
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