Coronary blood flow alternans a unique examination of coronary physiology and influence of intraaortic balloon pumping

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From our observation that initial distribution of 201T1 in tissue is mainly dependent on blood flow distribution, we designed the method to obtain the rates of change of coronary blood flow and coronary vascular resistance and applied it to the analysis of coronary hemodynamics in patients with ischemic heart disease during submaximal exercise. We measured the rates of change of cardiac output (delta CO) and myocardial blood flow distribution (delta Fract ) in two occasions by the sequential two injections of T1, and obtained the rate of change...

The dominant coronary arteries and coronary supply types were determined by means of coronary topograms plotted from 305 coronary angiograms, including 30 postmortem ones. Coronary supply types were expressed by the following ratios of numeral values: 5:15, 6:14, 7:13, 8:12, 9:11, 10:10, 11:9, which corresponded to mass scores of the areas supplied through the right (RCA) and the left (LCA) coronary artery. Such determination of coronary supply types in postmortem examinations was verified by separate weighing of the RCA and LCA basins. The dat...

Effects of 6 coronary vasodilators on the coronary blood flow and the contractile force of the ventricular muscle were examined simultaneously by injecting these drugs to the arterially blood-perfused canine papillary muscle preparation. All compounds produced a dose-dependent increase in blood flow rate, and relative potencies determined on the basis of doses producing a 100% increase in blood flow rate, ED100, were in the descending order : nifedipine greater than verapamil greater than diltiazem greater than dilazep greater than dipyridamole...

Simultaneous measurement of coronary venous oxygen saturation and coronary venous blood flow is an essential method that reveals myocardial oxygen metabolism. But there have been no reports of the simultaneous measurements during warm blood cardioplegic infusion in cardiac surgery. Thirteen patients underwent elective coronary artery bypass grafting in our unit. Simultaneous measurement of coronary venous oxygen saturation (ScsO2) and coronary venous blood flow (Fcs) was carried out during terminal warm blood cardioplegia. Fcs increased rapidly...

The effects of i.v. dipyridamole were studied in 9 patients with isolated total left anterior descending coronary artery (LAD) obstruction, in 6 patients with isolated 90 to 99% diameter reduction of the LAD and in 10 patients with normal coronary arteries and normal left ventricular function. Coronary sinus and great cardiac vein flows were determined by continuous thermodilution. Flows were measured at rest and 1, 3, 5 and 10 minutes after i.v. dipyridamole. Great cardiac vein flow represents the venous outflow from the LAD territory. In the ...

In order to evaluate the role of adrenergic receptor-mediated vasomotions of large epicardial coronary arteries in changing coronary blood flow (CBF), the effects of intracoronary norepinephrine (NE), 1.0 microgram/min, were examined in dogs with coronary stenosis which preserved stenosis vasomobility. In untreated dogs, NE caused no significant changes in CBF and stenosis resistance (SR). In dogs treated with propranolol, NE decreased CBF by 65 +/- 7.0% (mean +/- SE) and produced 12-fold intensification of SR followed by LV dP/dt reduction. Si...

In the present study, we report the finding that some patients with spontaneous typical angina and angiographically normal coronary arteries present an abnormal cardiocoronary capacity to produce thromboxane A2, both in basal conditions and after sympathetic stimulation. The levels of thromboxane A2 in coronary sinus are significantly correlated to the rate of clearance of contrast medium in coronary circulation. Such a finding might be useful in better understanding the interesting syndrome of angina with normal coronary arteries.

OBJECTIVES: Quantitative assessment of coronary collateral blood flow can be archived by measuring coronary pressure. We studied the relationships between recruitable coronary collateral blood flow and electrocardiographic changes during percutaneous coronary intervention (PCI). METHODS: We measured coronary pressure during coronary occlusion with PCI in 119 patients with left anterior descending coronary artery stenosis. During balloon inflation, the electrocardiogram was continuously recorded. The ST-segment elevation in the most elevated lea...