TITLE

Post-stenotic coronary blood flow at rest is not altered by therapeutic doses of the oral antidiabetic drug glibenclamide in patients with coronary artery disease

AUTHOR(S)
Reffetmonn, T.; Klues, H. G.; Hanrath, P.; Schwarz, E. R.
PUB. DATE
January 2002
SOURCE
Heart;Jan2002, Vol. 87 Issue 1, p54
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Objective: To investigate whether blood flow in normal and post-stenotic coronary arteries is altered by therapeutic doses of the sulfonylurea agent glibenclamicle. Patients: 12 patients with a high grade stenosis of the left anterior descending coronary artery (n = 10) or left circurnflex coronary artery (n = 2), and an angiogrophically normal corresponding left circumflex artery or left anterior descending artery, respectively. Design: Two Doppler ultrasound wires were positioned in the "normal" and post-stenotic artery for simultaneous measurements of coronary blood flow velocity under baseline conditions and after intra- venous glibenclamide, 0.05 mg/kg body weight. Local coronary blood flow was calculated from the average peak velocity and the cross sectional area, derived from quantitative coronary angiograph.ic analysis. Coronary flow reserve was determined after intracoronary injection of 30 μg adenosine and 12 mg papaverine. Results: One hour after glibenclamide, serum insulin increased from (mean (SD)) 7.4 (2.0). to 44.8 (25.5) mU/I (p < 0.005), and C peptide from 1.4 (0.4) to 3.4 (1 .2), ng/i (p = 0.005). In normal coronary arteries coronary Bow reserve was 2.6 (0.4) after adenosine and 3.0 (0.4) after papaverine, while in post-stenotic arterial segments it was 1 .2 (0.3) after adenosine (p = 0.005) and 1 .3 (0.3) after papaverine (p = 0.005). There was no significant difference after glibenclamide. In non-stenotic arteries, average peak velocity (18.8 (5.2) cm/s) and calculated coronary blood flow (23.8 (10.7) ml/min) were not altered by glibenclamide (18.3 (5.2) cm/s and 22.8 (10.4) ml/min, respectively). In post-stenotic arteries, baseline average peak velocity was 13.3 (4.9) ml/min and coronary blood flow was 9.1 (3.0) ml/min, without significant change after glibenclamide (13.3 (5.2) cm/s, 9.0 (3.2) ml/ min).
ACCESSION #
12998784

 

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