Document Detail

Intermittent coronary sinus occlusion after coronary arterial ligation results in venous retroperfusion.
MedLine Citation:
PMID:  2766489     Owner:  NLM     Status:  MEDLINE    
Coronary sinus occlusion retards necrosis of ischemic myocardium. To test the hypothesis that coronary sinus occlusion induces retrograde venoarterial flow, the coronary arteriovenous pressure gradient and the coronary arterial oxygen saturation were measured distal to a left anterior descending coronary artery ligature in dogs. In parallel, we constructed a mathematical model of known coronary physiology to characterize pressure and flow patterns during coronary sinus occlusion. In dogs, coronary sinus occlusion produced a systolic pressure gradient between the coronary artery and the coronary sinus of -20 +/- 9 mm Hg (higher venous pressure, p less than 0.0001) and a positive diastolic gradient of 3 +/- 5 mm Hg (lower venous pressure p less than 0.01). An average reduction in the oxygen saturation in the ligated coronary artery of 20 +/- 13% was also observed (p less than 0.005) consequent to admixture of venous (desaturated) blood. By graded inflation of the coronary sinus balloon, it was demonstrated that desaturation of arterial blood typically occurs above a coronary sinus systolic pressure of 40-50 mm Hg. The mathematical model indicates the possibility of venoarterial pressure gradients and reversal of flow at the microcirculatory level during coronary sinus occlusion. These studies provide evidence that retrograde flow into the ischemic zone occurs in association with intermittent coronary sinus occlusion. Thus, alternating flow over the ischemic territory may be the mechanism of myocardial salvage during intermittent coronary sinus occlusion.
R Beyar; A D Guerci; H R Halperin; J E Tsitlik; M L Weisfeldt
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Circulation research     Volume:  65     ISSN:  0009-7330     ISO Abbreviation:  Circ. Res.     Publication Date:  1989 Sep 
Date Detail:
Created Date:  1989-10-03     Completed Date:  1989-10-03     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0047103     Medline TA:  Circ Res     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  695-707     Citation Subset:  IM    
Peter Belfer Laboratory for Myocardial Research, Johns Hopkins Medical Institutions, Baltimore, MD 21205.
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MeSH Terms
Blood Pressure
Coronary Circulation*
Coronary Disease / physiopathology*
Coronary Vessels / physiology*,  physiopathology
Models, Theoretical*
Oxygen / blood
Reference Values
Grant Support
Reg. No./Substance:

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