Right coronary artery flow impairment in patients with pulmonary hypertension.

Abstract:

AIMS:This study investigates whether increased right ventricular (RV) pressure in pulmonary hypertension (PH) impairs right coronary artery (RCA) flow and RV perfusion. METHODS:In 25 subjects, five patients with idiopathic pulmonary arterial hypertension, nine patients with chronic thromboembolic pulmonary arterial hypertension, and 11 healthy controls, flow of the RCA and left anterior descending (LAD) artery was measured with MR flow quantification. RESULTS:In PH, RCA peak systolic and mean systolic flow were lower, 1.02 +/- 0.62 mL/s and 0.42 +/- 0.30 mL/s, than peak and mean diastolic flow, 2.99 +/- 1.97 mL/s (P < 0.001) and 1.73 +/- 0.97 mL/s (P < 0.001); a pattern similar to the LAD. In contrast, in controls, RCA peak and mean flow in systole, 1.63 +/- 0.58 mL/s and 0.72 +/- 0.23 mL/s, were comparable to peak and mean flow in diastole, 1.72 +/- 0.48 mL/s and 0.93 +/- 0.28 mL/s (NS). The systolic-to-diastolic flow ratio in the RCA, and mean flow per gram RV tissue, were inversely related to RV mass, R = -0.61 (P = 0.009), and R = -0.73 (P < 0.001) and to RV pressure, R = -0.83 (P < 0.001), and R = -0.57 (P = 0.033). CONCLUSION:Although in controls, RCA flow is similar in systole and diastole, in PH there is systolic flow impediment, which is proportional to RV pressure and mass. In patients with severe RV hypertrophy total mean flow is reduced.

journal_name

Eur Heart J

journal_title

European heart journal

authors

van Wolferen SA,Marcus JT,Westerhof N,Spreeuwenberg MD,Marques KM,Bronzwaer JG,Henkens IR,Gan CT,Boonstra A,Postmus PE,Vonk-Noordegraaf A

doi

10.1093/eurheartj/ehm567

subject

Has Abstract

pub_date

2008-01-01 00:00:00

pages

120-7

issue

1

eissn

0195-668X

issn

1522-9645

pii

ehm567

journal_volume

29

pub_type

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