Document Detail


Coronary reserve in volume-induced right ventricular hypertrophy from atrial septal defect.
MedLine Citation:
PMID:  6238518     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
To assess coronary reserve in patients with right ventricular (RV) hypertrophy secondary to volume overload, the quantitative characteristics of coronary reactive hyperemia were examined in 20 patients with a large atrial septal defect (ASD). The control group consisted of 13 patients who had undergone elective cardiac surgery for abnormalities that did not involve the right ventricle or its blood supply. Coronary blood flow velocity was measured in RV branches of the right coronary artery at cardiac surgery. Echocardiographic measurements of RV diameter in ASD and in control patients (2.3 +/- 0.2 and 1.1 +/- 0.2 cm, respectively, p less than 0.05) documented the presence of substantial RV enlargement in patients with ASD. In patients with ASD and in control subjects, a 20-second coronary occlusion produced maximal coronary dilation. After release of a 20 second coronary occlusion, the peak-to-resting velocity ratio in ASD and in control patients was 3.1 +/- 0.2 and 5.5 +/- 0.1, respectively (p less than 0.05). The 50% decrease in the ratio of peak-to-resting coronary blood flow velocity, a measure of relative coronary reserve, in patients with ASD suggests that coronary reserve is compromised in volume-induced RV hypertrophy. These studies support the concept that in humans, volume-induced RV hypertrophy substantially decreases coronary reserve.
Authors:
D B Doty; C B Wright; L F Hiratzka; C L Eastham; M L Marcus
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Publication Detail:
Type:  Journal Article; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American journal of cardiology     Volume:  54     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  1984 Nov 
Date Detail:
Created Date:  1984-12-05     Completed Date:  1984-12-05     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1059-63     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Blood Flow Velocity
Cardiomegaly / etiology,  physiopathology*,  surgery
Child
Child, Preschool
Coronary Circulation*
Echocardiography
Heart Septal Defects, Atrial / complications,  physiopathology*,  surgery
Humans
Hyperemia
Intraoperative Period
Middle Aged
Grant Support
ID/Acronym/Agency:
HL 14388/HL/NHLBI NIH HHS; HL 20827/HL/NHLBI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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