Quantification of O2 consumption and arterial pressure as independent determinants of coronary flow

1987 ◽  
Vol 252 (3) ◽  
pp. H545-H553 ◽  
Author(s):  
I. Vergroesen ◽  
M. I. Noble ◽  
P. A. Wieringa ◽  
J. A. Spaan
Keyword(s):  
Coronary Artery ◽  
Arterial Pressure ◽  
Coronary Flow ◽  
Left Main Coronary Artery ◽  
External Pressure ◽  
Arterial Blood Flow ◽  
O2 Consumption ◽  
Left Main ◽  
Arterial Blood ◽  
Wide Range

The steady-state relationship between coronary arterial blood flow (CBF) and both myocardial O2 consumption (MVO2) and coronary arterial pressure (P) was explored in anesthetized dogs and goats. Both species were subjected to constant pressure perfusion of the left main coronary artery by an external pressure-controlling circuit. In addition a group of goats was studied with normal aortic perfusion using an occluder around the left main coronary artery to vary coronary arterial pressure. The statistical analysis revealed that despite the direct effect of P on MVO2 (the Gregg effect) the effects of both variables on CBF were independent and linear over a wide range of P and MVO2 so that multiple regression analysis with a linear equation (CBF = a X P + b X MVO2 + c) gave an excellent fit which was not improved by the introduction of an addition interactive term b3MVO2 X P. The mean correlation coefficient for all animals was greater than 0.9. From these data we conclude that any factor regulating coronary arterial flow would be influenced by both MVO2 and perfusion pressure in an independent way. This study characterizes the stationary behavior of local coronary flow control. Hence, it specifies quantitatively the relations to be predicted by hypotheses aiming to explain this control mechanism.

Preliminary observations on blood flow in the coronary arteries of two school sharks (Galeorhinus australis)

1993 ◽  
Vol 71 (6) ◽  
pp. 1238-1241 ◽  
Author(s):  
Peter S. Davie ◽  
Craig E. Franklin
Keyword(s):  
Blood Flow ◽  
Arterial Pressure ◽  
Coronary Blood Flow ◽  
Coronary Flow ◽  
Cardiac Cycle ◽  
Arterial Blood Flow ◽  
Ventricular Systole ◽  
Arterial Blood ◽  
Ventricular Mass ◽  
Aortic Blood Velocity

Coronary arterial blood flow and pressure, intraventricular blood pressure, and ventral aortic blood velocity were measured in two anaesthetized school sharks (Galeorhinus australis) in order to examine the phasic relationships between these flows and pressures. Maximum instantaneous flow recorded in the ventral coronary artery was 0.37 mL∙min−1∙kg−1 body mass (estimated 0.63 mL∙min−1∙g−1 ventricular mass). The average mean coronary blood flow was estimated as 0.28 mL∙min−1∙g−1 ventricular mass during periods of high coronary blood flow. On average, 86% of coronary flow occurred during diastole. Coronary arterial flow began during the last quarter of ventricular systole. Coronary blood flow peaked when intraventricular pressure fell to just below zero immediately after ventricular systole. Coronary blood flow fell slightly as diastole continued and reflected the small fall in coronary arterial pressure. Coronary flow reversed briefly during isovolumic ventricular contraction. Increases in the proportion of the cardiac cycle occupied by ventricular diastole, which occur during hypoxic bradycardia, have the potential to more than double coronary blood flow provided coronary arterial pressure is maintained.

scholarly journals Stent dislodgement in the distal left main coronary artery and its successful management with balloon crushing technique

2015 ◽  
Vol 72 (5) ◽  
pp. 454-457
Author(s):  
Zoran Stajic
Keyword(s):  
Coronary Artery ◽  
Coronary Flow ◽  
Left Main Coronary Artery ◽  
Coronary Intervention ◽  
Anterior Wall ◽  
Left Main ◽  
Unstable Patient ◽  
Percutaneous Coronary ◽  
St Elevation ◽  
Percutanous Coronary Intervention

Introduction. Stent entrapment and dislodgment in the coronary arteries is a rare but potentially fatal complication of percutaneous coronary intervention. Different retrival techniques of dislodged stents have previously been reported with high success rate but all of them are timeconsuming, so as not quite useful in hemodinamically unstable patient. Case report. A 59-year old female patient with acute ST-elevation myocardial infaction of anterior wall was admitted for primary percutanous coronary intervention. Unexpectedly, during intervention stent entrapment and dislodgement in the distal left main coronary artery occured followed by occlusive coronary dissection and compromisation of the coronary flow in the left descending coronary artery with a rapid hemodinamic deterioration. In order to reestablish coronary flow as soon as possible, the dislodged unexpanded stent was crushed against the wall with a balloon in the distal left main. It immediately restored coronary flow in the left descending coronary artery and rapidly improved the patients hemodinamics. Intervention was successfuly completed with totally four stents implanted in the left main, the osteoproxymal circumflex coronary artery and the osteo-proxymedial left descending coronary artery. Later postinterventional hospital course as well as the clinical and angiographic six month follow-up was uneventful. Conclusion. This case shows that percutaneous baloon crushing technique can be a safe and effective first option in management of dislodged and unexpanded stent in the left main coronary artery, particularly for a hemodynamically unstable patient.

scholarly journals Angiographic determinants for side branch treatment in distal unprotected left main coronary artery bifurcation percutaneous coronary intervention with single stent crossover technique

2019 ◽  
Vol 7 (8) ◽  
pp. 3005
Author(s):  
V. S. R. Bhupal ◽  
P. Sampath Kumar
Keyword(s):  
Coronary Artery ◽  
Left Main Coronary Artery ◽  
Coronary Intervention ◽  
Side Branch ◽  
Syntax Score ◽  
Left Main ◽  
Bifurcation Angle ◽  
Percutaneous Coronary ◽  
Wide Range ◽  
Plain Old Balloon Angioplasty

 Background: The aim of this study was to analyze angiographic parameters such as bifurcation angle, diameter at the polygon of confluence (POC) and SYNTAX score in predicting the need for side branch treatment with single-stent crossover technique from distal unprotected left main coronary artery (ULMCA) to the major side branch.Methods: This was a retrospective and observational study. A total of 83 patients with distal ULMCA lesions were enrolled. Patients who underwent provisional single-stent crossover technique were compared with patients that required side branch treatment though plain old balloon angioplasty (POBA) 5 (6.0%) or stenting 7 (8.4%). Angiographic parameters, bifurcation angle, diameter at the POC and the SYNTAX score were analyzed for their ability to predict the need for side branch treatment.Results: Mean age of patients was 58.2±5.3 years. Males constituted 61 (73.5%) patients. Post main branch stenting 5 (6.0%) and 7 (8.4%) patients required side branch treatment with POBA and stent implantation, respectively. Binary regression revealed bifurcation angle (Z: 1.15, OR: 0.99, 95% CI: 0.97-1.01, p=0.25), diameter at the POC (Z: 1.1, OR: 0.82, 95% CI: 0.32-2.13, p=0.272) and SYNTAX score (Z: 1.51, OR: 1.18, 95% CI: 0.95-1.45, p=0.132) did not correctly predict the requirement of side branch treatment.Conclusion: Left main coronary artery to main branch stenting can be performed safely with single-stent crossover technique, irrespective of presence of side branch disease across a wide range of bifurcation angles, diameters at the POC and SYNTAX scores. 

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