| Instantaneous diastolic pressure-flow relationship in arterial coronary bypass grafts. | |
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MedLine Citation:
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PMID: 16438765 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The objective of this study was to describe the diastolic pressure-flow relationship and to assess critical occlusion pressure in arterial coronary bypass grafts in human beings. METHODS AND RESULTS: Fifteen patients were studied following elective surgical coronary artery bypass grafting. Flow in the left internal mammary artery bypass to the left anterior descending artery was measured and simultaneously, aortic pressure, coronary sinus pressure and left ventricular end-diastolic pressure were recorded. The zero-flow pressure intercept as a measure of critical occlusion pressure was extrapolated from the linear regression analysis of the instantaneous diastolic pressure-flow relationship. Mean diastolic flow was 46 +/- 17 mL min(-1), mean diastolic aortic pressure was 60.5 +/- 10.0 mmHg. Diastolic blood flow was linearly related to the respective aortic pressure in all patients (R-values 0.7-0.99). The regression lines had a mean slope of 2.1 +/- 1.2 mL min(-1) mmHg(-1). Mean critical occlusion pressure was 32.3 +/- 9.9 mmHg and exceeded mean coronary sinus pressure and mean left ventricular end-diastolic pressure by factors of 3.1 and 2.6, respectively. CONCLUSIONS: Our data demonstrate the presence of a vascular waterfall phenomenon in the coronary circulation after internal mammary artery bypass grafting. Critical occlusion pressure in arterial grafts considerably exceeds coronary sinus pressure as well as left ventricular end-diastolic pressure and should thus be used as the effective downstream pressure when calculating coronary perfusion pressure. Our data further suggest that the slope of diastolic pressure-flow relationships provides a more rational approach to assess regional coronary vascular resistance than conventional calculations of coronary vascular resistance. |
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Authors:
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S Kazmaier; G-G Hanekop; M Grossmann; H Dörge; K Götze; F Schöndube; M Quintel; A Weyland |
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Publication Detail:
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Type: Clinical Trial; Journal Article Date: 2006-01-27 |
Journal Detail:
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Title: European journal of anaesthesiology Volume: 23 ISSN: 0265-0215 ISO Abbreviation: Eur J Anaesthesiol Publication Date: 2006 May |
Date Detail:
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Created Date: 2006-03-31 Completed Date: 2006-09-28 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8411711 Medline TA: Eur J Anaesthesiol Country: England |
Other Details:
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Languages: eng Pagination: 373-9 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology, Emergency Medicine and Intensive Care, Georg-August-University, Germany. skazmai@gwdg.de |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Blood Flow Velocity / physiology Blood Pressure / physiology Coronary Artery Bypass* Coronary Circulation / physiology* Diastole / physiology* Female Humans Linear Models Male Mammary Arteries / physiology*, transplantation Time Factors Vascular Resistance / physiology* Ventricular Function, Left / physiology |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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