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Effects of neuropeptide Y on coronary artery vasomotor tone

Session Poster Session 3

Speaker Giuseppe M C Rosano

Event : Heart Failure 2016

  • Topic : heart failure
  • Sub-topic : Chronic Heart Failure: Comorbidities
  • Session type : Poster Session

Authors : G M C Rosano (Rome,IT), D Tousoulis (Athens,GR), E Mcfadden (London,GB), C Vitale (Rome,IT), JC Kaski (London,GB)

Authors:
G M C Rosano1 , D Tousoulis2 , E Mcfadden3 , C Vitale1 , JC Kaski3 , 1San Raffaele Pisana Hospital IRCCS - Rome - Italy , 2Hippokration General Hospital - Athens - Greece , 3St Georges Medical School - London - United Kingdom ,

Citation:
European Journal of Heart Failure Abstracts Supplement ( 2016 ) 18 ( Supplement 1 ), 361

Background: Patients with microvascular angina usually have a reduced coronary blood flow reserve. Neuropeptide Y (NPY) is a potent endogenous vasoconstrictor involved in modulation of coronary vasomotor tone and may play a role in microvascular angina. Methods. We compared the effects of NPY (0.2-1.0 pmol/kg, intracoronary) on the vasomotor response of proximal and distal segments of the coronary arteries in 7 patients with microvascular angina and left ventricular dysfunction (MALVD), 9 with chronic stable angina, and 9 control individuals. The coronary response to the administration of ergonovine was also assessed in 9 other patients with microvascular angina and normal LV function. Computerized coronary artery diameter measurements were carried out before (baseline) and after the administration of the vasoactive agents. Results: Mean baseline coronary lumen diameters were similar in control, MALVD, and coronary artery disease patients. NPY constricted proximal coronary segments by 8 ± 2%, 5 ± 2% and 6 ± 3% and distal segments by 14 ± 2%, 11 ± 2% and 10 ± 2% in control, MALD, and coronary artery disease patients, respectively (p=NS between groups). In patients with microvascular angina, ergonovine constricted proximal coronary segments by 7 ± 1.5% and distal segments by 12.5 ± 3% (p=NS vs. NPY). During NPY administration four MALVD patients developed chest pain, ST segment depression, and a marked lengthening of the contrast medium run off, in the absence of epicardial coronary artery spasm. Control individuals and coronary artery disease patients did not experience chest pain, ST segment shifts, or lengthening of the run off during NPY administration. Ergonovine administration caused chest pain and lengthening of the contrast run-off, in the absence of epicardial coronary artery spasm, in one patient with microvascular angina and normal LV function. Conclusions: Exogenous NPY causes mild epicardial coronary artery constriction which is similar in patients with non-cardiac chest pain, MALVD and coronary artery disease. Myocardial ischemia and marked lengthening of the contrast run off in response to NPY occurred in MALVD patients but not in control or coronary artery disease patients. An abnormal constrictor response to NPY at the microcirculation level could be the mechanism underlying the ischemic manifestations observed in patients with microvascular angina with LV dysfunction.

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