Document Detail


Prolonged diastolic time fraction protects myocardial perfusion when coronary blood flow is reduced.
MedLine Citation:
PMID:  10393684     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Because coronary blood flow is impeded during systole, the duration of diastole is an important determinant of myocardial perfusion. The aim of this study was to show that coronary flow modulates the duration of diastole at constant heart rate. METHODS AND RESULTS: In anesthetized, open-chest dogs, diastolic time fraction (DTF) increased significantly when coronary flow was reduced by lowering perfusion pressure from 100 to 70, 55, and 40 mm Hg. On average, DTF increased from 0.47+/-0.04 to 0.55+/-0.03 after a pressure step from 100 to 40 mm Hg in control, from 0.42+/-0.04 to 0.47+/-0.04 after administration of adenosine, and from 0.46+/-0.07 to 0.55+/-0.06 after L-NMMA (mean+/-SD, 6 dogs for control and adenosine, 4 dogs for L-NMMA, all P<0.05). Flow normalized to its value at full dilation and pressure of 90 mm Hg (375+/-25 mL/min) increased during the period of reduced pressure at 40 mm Hg; control, from 0.005+/-63 (2 seconds after pressure step) to 0.09+/-0.06 (15 seconds after pressure step); with adenosine, from 0.19+/-0.06 to 0. 22+/-0.06; and with L-NMMA, from 0.013+/-0.007 to 0.12+/-0.02 (all P<0.05). The increase in DTF at low pressure may be explained by a decrease in interstitial volume at low pressure, which either decreases the preload of the myocytes or reduces the buffer capacity for ions determining repolarization, thereby causing an earlier onset of relaxation. CONCLUSIONS: Because the largest increase in DTF occurs at pressures below the autoregulatory range when blood flow to the subendocardium is closely related to DTF, modulation of DTF by coronary blood flow can provide an important regulatory mechanism to match supply and demand of the myocardium when vasodilatory reserve is exhausted.
Authors:
D Merkus; F Kajiya; H Vink; I Vergroesen; J Dankelman; M Goto; J A Spaan
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Circulation     Volume:  100     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  1999 Jul 
Date Detail:
Created Date:  1999-07-16     Completed Date:  1999-07-16     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  75-81     Citation Subset:  AIM; IM    
Affiliation:
Department of Medical Physics, Cardiovascular Research Institute Amsterdam, Academic Medical Center, University of Amsterdam, The Netherlands.
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MeSH Terms
Descriptor/Qualifier:
Adenosine / pharmacology
Animals
Blood Pressure
Cardiac Pacing, Artificial
Cardiovascular Agents / pharmacology
Coronary Circulation / physiology*
Diastole / physiology*
Dogs
Enzyme Inhibitors / pharmacology
Heart / drug effects,  physiopathology
Muscle Relaxation
Myocardial Ischemia / physiopathology*
Myocardium / pathology
Nitric Oxide Synthase / antagonists & inhibitors
Nitric Oxide Synthase Type III
Perfusion
Time Factors
Vascular Resistance
omega-N-Methylarginine / pharmacology
Chemical
Reg. No./Substance:
0/Cardiovascular Agents; 0/Enzyme Inhibitors; 17035-90-4/omega-N-Methylarginine; 58-61-7/Adenosine; EC 1.14.13.39/Nitric Oxide Synthase; EC 1.14.13.39/Nitric Oxide Synthase Type III

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


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