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The pressure-flow relation in the canine coronary artery: combined effects of critical stenosis and intracoronary thrombosis.

Abstract：

OBJECTIVE:To characterise the effect of coronary intra-arterial thrombosis upon the downstream vascular bed. BACKGROUND:The vascular response downstream from a coronary intra-arterial thrombus has not previously been characterised. We postulated that downstream vasoconstriction might result from the presence of endothelial damage with consequent growth of platelet-rich thrombus. METHODS:We measured the pressure gradient and flow across, and the pressure/flow ratio distal to, a canine left circumflex artery stenosis with and without endothelial damage causing intracoronary thrombosis. We also observed the effects of transient complete conclusions. RESULTS:At occlusion, the pressure gradient was maximal; relief of occlusion caused a rapid increase flow and distal pressure with a rapid decrease in stenosis pressure gradient and resistance. Subsequently there was a period of stable stenosis resistance with pressure gradient and flow declining; distal pressure therefore increased at this time. Finally in the thrombus group only, stenosis resistance increased again towards re-occlusion. During occlusion, distal pressure averaged 49 +/- 18 mmHg in the presence of thrombus vs. 22 +/- 4 mmHg in its absence (P < 0.001). Following release of occlusion, the flow increased faster than distal pressure, so that the ratio (distal pressure/flow) fell rapidly. Subsequently, distal pressure continued to increase after flow had reached a peak and begun to decline, suggesting vasoconstriction. In the presence of thrombus, the distal pressure/flow ratio was higher than in the absence of thrombus, both at maximal vasodilation (P < 0.005) and at maximum vasoconstriction (P < 0.025). CONCLUSIONS:During cyclic flow variations the stenosis resistance changes are exactly as expected from thrombus growth and embolisation. The distal pressure/flow ratio showed a time-dependent increase which appeared greater when conditions favoured intracoronary thrombosis.

journal_name

Cardiovasc Res

journal_title

Cardiovascular research

authors

Belcher PR,Vergroesen I,Drake-Holland AJ,Noble MI

subject

Has Abstract

pub_date

1995-11-01 00:00:00

pages

807-14

issue

eissn

0008-6363

issn

1755-3245

pii

0008-6363(95)00127-1

journal_volume

pub_type

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The pressure-flow relation in the canine coronary artery: combined effects of critical stenosis and intracoronary thrombosis.