| Left ventricular myocardial blood flow in multivessel coronary artery disease. | |
| | |
MedLine Citation:
|
PMID: 7094265 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
The relationship between resting left ventricular (LV) myocardial blood flow (MBF) and hemodynamic determinants of myocardial oxygen consumption was investigated in 15 patients with multivessel coronary artery disease (CAD) and in 10 patients with normal coronary arteriograms. Mean LV MBF per unit mass of tissue was measured with a multicrystal scintillation camera from the regional clearance rates of xenon-133 injected into the left main coronary artery. Peak LV wall stress, mean velocity of circumferential fiber shortening (Vcf), rate of ejection during the first third of systole (1/3 SV), LV ejection fraction (EF), and the ratio of peak LV systolic pressure to LV end-systolic volume were measured by contrast left ventriculography. Mean LV MBF per unit mass was significantly reduced (48 +/- 11 vs 67 +/- 12 ml/100 g.min; p less than 0.01) in patients with multivessel CAD. However, none of the patients with CAD experienced chest pain or had electrocardiographic evidence of myocardial ischemia during the resting MBF measurements. Ejection phase indexes were lower in the patients with CAD: LVEF (56 +/- 10% vs 64 +/- 7%, p less than 0.05); 1/3 SV (35 +/- 3 vs 44 +/- 4%, p less than 0.05); and mean Vcf (1.05 +/- 0.30 vs 1.19 +/- 0.27 circ/sec, NS). LV wall thickness (9.8 +/- 1.9 vs 7.5 +/- 1.4 mm, p less than 0.01) and LV mass index (94 +/- 32 vs 64 +/- 17 g/m2, p less than 0.05) were significantly increased in the patients with CAD, accounting for the reduction in peak LV wall stress (276 +/- 73 vs 373 +/- 91 dyn-cm-2 x 10(-3), p less than 0.05) observed in these patients. Multiple regression analysis indicated that indexes of three of the major determinants of myocardial oxygen consumption explained 65% of the variation in MBF in patients with CAD: peak LV stress, mean Vcf and heart rate. After adjustment for these three indexes, the average LV MBF rates were not significantly different in the two patient groups (54.8 +/- 1.8 vs 57.6 +/- 2.3 ml/100 g.min). In both groups, resting LV MBF/beat correlated most highly with peak LV wall stress (r = 0.79). Thus, the reduction in LV MBF per unit mass observed in patients with multivessel CAD at rest is related to lower levels of hemodynamic variables that determine myocardial oxygen consumption. Peak LV wall stress is the most important hemodynamic variable determining the level of resting MBF in patients with and without CAD. |
| | |
Authors:
|
P H Chen; A B Nichols; M B Weiss; R R Sciacca; P D Walter; P J Cannon |
Related Documents
:
|
12738235 - Matrix metalloproteinase abundance in human myocardial fibroblasts: effects of sustaine... 21606045 - Transmural myocardial ischaemia complicating recovery after dobutamine-atropine stress ... 16216765 - Left atrial far-field sensing by left ventricular leads: a potential hazard in cardiac ... 17268205 - Feasibility of biventricular pacing in patients with recent myocardial infarction: impa... 1191205 - Heterodromia in accessory a-v connections. 18156545 - Pre-excited atrial fibrillation triggered by intravenous adenosine: a commonly used dru... |
Publication Detail:
|
Type: Journal Article; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
|
Title: Circulation Volume: 66 ISSN: 0009-7322 ISO Abbreviation: Circulation Publication Date: 1982 Sep |
Date Detail:
|
Created Date: 1982-09-17 Completed Date: 1982-09-17 Revised Date: 2007-11-14 |
Medline Journal Info:
|
Nlm Unique ID: 0147763 Medline TA: Circulation Country: UNITED STATES |
Other Details:
|
Languages: eng Pagination: 537-47 Citation Subset: AIM; IM |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Blood Flow Velocity Blood Pressure Coronary Angiography Coronary Circulation* Coronary Disease / physiopathology* Female Heart Rate Heart Ventricles / radiography Humans Male Middle Aged Myocardium / metabolism Oxygen Consumption Regression Analysis Stroke Volume |
| Grant Support | |
ID/Acronym/Agency:
|
HL-07114/HL/NHLBI NIH HHS; HL-14148/HL/NHLBI NIH HHS; HL-21006/HL/NHLBI NIH HHS |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Prognostic value of exercise testing, coronary angiography and left ventriculography 6--8 weeks afte...
Next Document: Pharmacologic modification of myocardial ischemia.