Document Detail


Effects of heart rate on phasic Y-graft blood flow and flow reserve in patients with complete arterial myocardial revascularizaton: an intravascular Doppler catheter study.
MedLine Citation:
PMID:  12853049     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: It is not well established whether the blood flow of arterial composite Y-grafts can efficiently respond to the flow demand of the coronary system early postoperatively. The aim of this study was to evaluate if soon after the operation, arterial composite Y-grafts can increase blood flow in response to an increase in myocardial oxygen consumption (MVO2). METHODS: Twenty-seven patients who received complete arterial myocardial revascularization using the left internal thoracic artery (LITA) and the radial artery (RA) as composite Y-graft gave their consent to a pre-discharge coronary angiography and intravascular flow velocity measurements using a Doppler guide wire. Flow measurements were performed in the LITA main stem, the distal LITA and the RA, both at rest and during atrial pacing at the 85% of the patient age-predicted maximum. The heart rate-systolic blood pressure product was considered as an indirect index of MVO2. Hyperemic flow was determined after injection of adenosine. The flow reserve (FR) was defined as the ratio of blood flow during maximal hyperemia (Qmax) to baseline flow (Qbasal). RESULTS: Atrial pacing increased MVO2 significantly (P<0.000). None of the patients developed ischemic S-T segment modifications or complained of chest pain. Q(basal) increased significantly in the LITA main stem (P=0.001), distal LITA (P=0.041) and RA (P=0.004) while Qmax did not change significantly. As a consequence, the FR decreased in the LITA main stem (P=0.002), distal LITA (P<0.000) and RA (P<0.000) but was not completely exhausted. CONCLUSIONS: Soon after the operation, arterial composite Y-grafts can significantly increase blood flow in response to conditions of increased MVO2, keeping normal the myocardial O2 supply-to-demand ratio.
Authors:
Massimo Lemma; Andrea Mangini; Guido Gelpi; Andrea Innorta; Paolo Danna; Francesco Lavarra; Emanuela Piccaluga; Carlo Antona
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery     Volume:  24     ISSN:  1010-7940     ISO Abbreviation:  Eur J Cardiothorac Surg     Publication Date:  2003 Jul 
Date Detail:
Created Date:  2003-07-10     Completed Date:  2003-11-10     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8804069     Medline TA:  Eur J Cardiothorac Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  81-5; discussion 85     Citation Subset:  IM    
Affiliation:
Division of Cardiovascular Surgery, L. Sacco Hospital, Via G.B. Grassi 74, 20157 Milan, Italy. massimo.lemma@fastwebnet.it
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Flow Velocity
Cardiac Pacing, Artificial
Coronary Circulation
Coronary Disease / metabolism,  physiopathology*,  surgery*
Heart Catheterization
Heart Rate / physiology*
Humans
Laser-Doppler Flowmetry
Male
Mammary Arteries / surgery
Middle Aged
Myocardial Revascularization*
Myocardium / metabolism
Oxygen Consumption
Patient Selection
Radial Artery / surgery
Ultrasonography, Interventional

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


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