Key result
Adenosine and nitroglycerin uniformly dilated 20- to 500-micron coronary arterioles, but adenosine caused a much more pronounced decrease in coronary vascular resistance (-76% vs -29% for NTG).
May guide coronary vasomotor testing interpretation; leaves open human translation and clinical relevance.
We investigated the effects of adenosine and nitroglycerin (NTG) on coronary microvessel diameters (intravital fluorescence microscopy) and coronary perfusion (radioactive microspheres). Measurements were performed during baseline conditions (intravenous piritramid) and during controlled hypotension (mean arterial pressure approximately 60 mmHg) induced by halothane, adenosine, and NTG. Coronary vascular resistance (CVR) remained unchanged during halothane (-7%) but decreased during adenosine (-76%) and NTG (-29%). Coronary arteriolar diameters increased during all experimental steps. In the smallest vessels (20-40 microns), diameters increased by 14, 43, and 42% during halothane-, adenosine-, and NTG-induced hypotension, respectively. Diameter increases were less pronounced in larger vessels. The uniform action of adenosine and NTG in 20- to 500-microns arterial vessels is in contrast to the pronounced differences in reduction of CVR. Preferential dilation of arterioles < 20 microns or recruitment of coronary microvessels by adenosine might account for the more pronounced decrease of CVR during adenosine. Intracoronary application of adenosine (0.8 mg.kg-1.h-1) and NTG (1, 5, and 25 micrograms.kg-1.h-1) equally caused near-maximum dilation of coronary arterioles > 100 microns. However, NTG dilation of arterioles < 100 microns was dose dependent and exceeded large-vessel dilation only with the highest concentration of NTG.
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Habazettl et al. (1994) studied this question. Adenosine and nitroglycerin vs. Baseline conditions and halothane was evaluated on Coronary microvessel diameters and coronary vascular resistance. Adenosine and nitroglycerin uniformly dilated 20- to 500-micron coronary arterioles, but adenosine caused a much more pronounced decrease in coronary vascular resistance (-76% vs -29% for NTG).
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