Epicardial coronary venous pressure

1981 ◽  
Vol 59 (12) ◽  
pp. 1250-1259 ◽  
Author(s):  
J. A. Armour ◽  
G. A. Klassen
Keyword(s):  
Coronary Artery ◽  
Coronary Sinus ◽  
Pressure Wave ◽  
Venous Pressure ◽  
Side Branch ◽  
Canine Heart ◽  
Coronary Vein ◽  
Intramyocardial Pressure ◽  
Wave Forms ◽  
Peak Pressures

Coronary venous pressure was measured in two sites in the canine heart. Central coronary venous pressure was that pressure recorded by a catheter in an epicardial coronary vein directed antegrade towards the coronary sinus. This pressure was 6 ± 1/0.2 ± 0.6 mmHg (1 mmHg = 133.322 Pa). Peripheral coronary venous pressure was recorded by a catheter in an epicardial vein which was directed towards the apex. It was 27 ± 5/8 ± 2 mmHg. Simultaneous measurement of peripheral coronary artery and vein pressures demonstrated similar pressure wave forms with peak pressures during systole. Peripheral coronary venous pressure was similar if measured from a side branch leading to the major epicardial veins or via a catheter placed retrograde in a major epicardial vein. Thus artifact of measurement caused by antegrade catheter placement was negligible. During norepinephrine administration, venous pressures were significantly increased. These data suggest that coronary venous pressures are higher than is generally assumed and that intramyocardial pressure has an important effect upon coronary venous pressure.

Pressure and flow in epicardial coronary veins of the dog heart: responses to positive inotropism

1984 ◽  
Vol 62 (1) ◽  
pp. 38-48 ◽  
Author(s):  
J. A. Armour ◽  
G. A. Klassen
Keyword(s):  
Coronary Artery ◽  
Coronary Sinus ◽  
Venous Pressure ◽  
Stellate Ganglion ◽  
Canine Heart ◽  
Coronary Vein ◽  
Venous Flow ◽  
Coronary Veins ◽  
Coronary Sinus Flow ◽  
The Right

Peripheral coronary venous pressures and coronary sinus venous flow were measured in the canine heart as well as intramyocardial, intraventricular, aortic, and coronary artery pressures. Maximum coronary venous flow occurred after maximum intramyocardial and peripheral coronary artery pressures had been reached. Maximum venous flow occurred at or following the maximum peripheral coronary vein pressure. Positive inotropic changes induced by stimulation of the right or left stellate ganglia or infusing isoproterenol, norepinephrine, or dobutamine significantly increased intramyocardial pressure, systolic epicardial coronary venous pressure, and systolic coronary venous flow. Mean coronary sinus flow was augmented by all interventions except isoproterenol. The estimated systolic vein resistance was slightly increased following right stellate ganglion stimulation, but not following left stellate ganglion stimulation, isoproterenol, or dobutamine. Norepinephrine reduced this parameter minimally. These data indicate that coronary veins respond differently to a variety of different positive inotropic interventions.

Coronary venous pressure and flow: effects of vagal stimulation, aortic occlusion, and vasodilators

1984 ◽  
Vol 62 (5) ◽  
pp. 531-538 ◽  
Author(s):  
G. A. Klassen ◽  
J. A. Armour
Keyword(s):  
Coronary Artery ◽  
Venous Pressure ◽  
Left Ventricular ◽  
Canine Heart ◽  
Mean Flow ◽  
Venous Flow ◽  
Intramyocardial Pressure ◽  
Coronary Sinus Flow ◽  
Venous Resistance ◽  
Flow Effects

Coronary venous pressure and coronary sinus flow in the canine heart were compared with intramyocardial, intraventricular, aortic, and coronary artery pressures. Stimulation of the thoracic vagus augmented coronary venous pressure, mean venous flow per systole, and coronary venous systolic resistance, but decreased the mean venous flow. Partial occlusion of the aorta augmented coronary venous pressure and coronary venous flow, while systolic coronary venous resistance remained unchanged. Adenosine increased peripheral and central coronary venous pressure and venous flow; it reduced peripheral coronary artery presure. Adenosine augmented flow per systole and reduced venous resistance more than the other interventions. Dipyridamole decreased left ventricular, aortic, and central coronary artery systolic pressures and systolic venous resistance. It increased the venous flow, mean flow per systole, and coronary venous pressure, even though intramyocardial pressure remained unchanged. Nitroglycerine elevated coronary venous pressure and flow, as well as venous flow per systole, even though it decreased left ventricular, aortic, and central coronary artery pressures. Nitroglycerine significantly decreased coronary venous resistance. It is concluded that coronary venous resistance may be an important resistive component to consider when the total coronary circulation is studied.

Canine coronary venous pressures: responses to positive inotropism and vasodilation

1983 ◽  
Vol 61 (3) ◽  
pp. 213-221 ◽  
Author(s):  
G. A. Klassen ◽  
J. A. Armour
Keyword(s):  
Coronary Artery ◽  
Arterial Pressure ◽  
Venous Pressure ◽  
Systolic Pressure ◽  
Aortic Occlusion ◽  
Venous Tone ◽  
Coronary Veins ◽  
Artery Pressure ◽  
Intramyocardial Pressure ◽  
Positive Inotropism

The epicardial coronary venous pressure in 16 dogs was compared with coronary arterial pressure as well as aortic, intraventricular, and intramyocardial pressures. Partial aortic occlusion augmented intraventricular (IVP), intramyocardial (IMP), aortic (AP), and coronary arterial pressures. Peripheral coronary venous pressure was also elevated. Dobutamine significantly augmented IVP and IMP but not aortic or central coronary artery pressures; this agent significantly elevated coronary venous systolic pressure (28/8 to 84/12 mmHg) (1 mmHg = 133.322 Pa). Nitroglycerine decreased IVP, IMP, and AP significantly. Central coronary arterial pressure also fell significantly, but coronary venous pressures remained unchanged. In contrast dipyridamole resulted in no change in IVP, IMP, AP, or coronary arterial systolic pressures; however, the peripheral coronary venous systolic pressure became significantly elevated. Thus the two vasodilators, nitroglycerine and dipyridamole, had different effects upon coronary venous pressure. These data reinforce the recently expressed view that coronary veins behave in a complex fashion and further suggest that their pressures are dependent upon coronary artery pressure, intramyocardial pressure, and coronary venous tone.

Epicardial coronary venous pressures: autonomic responses

1982 ◽  
Vol 60 (5) ◽  
pp. 698-706 ◽  
Author(s):  
G. A. Klassen ◽  
J. A. Armour
Keyword(s):  
Coronary Artery ◽  
Vagal Stimulation ◽  
Venous Pressure ◽  
Outflow Tract ◽  
The Other ◽  
Sympathetic Stimulation ◽  
Pressure Regulation ◽  
Autonomic Responses ◽  
Intramyocardial Pressure

Intramyocardial, ventricular, aortic, and central and peripheral coronary artery as well as peripheral and central coronary venous pressures were measured simultaneously in dog hearts. A gradient of coronary vascular pressures was detected and quantitated. Stellate stimulation increased all pressures. Isoproterenol induced outflow tract obstructions so that aortic and central coronary artery pressures were unchanged while the other pressures increased. Vagal stimulation dissociated the intramyocardial venous pressure relationship in as much as arterial pressures decreased while epicardial coronary venous pressure was increased. These data suggest that coronary venous pressure in response to sympathetic stimulation increases as intramyocardial pressure increases. However, vagal stimulation permits a dissociation of these effects suggesting that coronary venous pressure regulation is complex.

Cessation of arterial and venous flow at a finite driving pressure in porcine coronary circulation

1984 ◽  
Vol 246 (4) ◽  
pp. H525-H531 ◽  
Author(s):  
R. F. Bellamy ◽  
J. D. O'Benar
Keyword(s):  
Coronary Artery ◽  
Arterial Pressure ◽  
Coronary Sinus ◽  
Time Course ◽  
Coronary Circulation ◽  
Venous Pressure ◽  
Pressure Change ◽  
Arterial Flow ◽  
Venous Flow ◽  
Artery Flow

We investigated the hypothesis that coronary capacitance is responsible for epicardial coronary artery flow stopping at arterial pressures greater than the coronary venous pressure. Using an in situ blood-perfused swine heart preparation, we compared the arterial pressures at which coronary artery inflow and coronary sinus outflow ceased. A pressure change was used that had the time course of aortic pressure during diastole. Data were obtained in hypocalcemic-arrested, adenosine-vasodilated preparations before and after pharmacologic interventions simulating the coronary circulation of the intact beating heart. The effect of extravascular compression was studied with barium contracture, while acetylcholine was infused to increase coronary vasomotor tone. The arterial pressure when arterial flow ceased was 13 +/- 5 mmHg in the arrested-vasodilated preparations, 37 +/- 10 mmHg after acetylcholine, and from 18 to 150 mmHg during barium contracture. Coronary sinus outflow ceased when arterial pressure was slightly less than the arterial pressure at which arterial flow had stopped. The differences between the arterial and venous zero flow arterial pressures were as follows: arrested-vasodilated 4 +/- 3 mmHg, acetylcholine 9 +/- 4, and barium contracture 0 +/- 3. The arteriovenous pressure gradients across the coronary bed at the instant venous flow ceased were as follows: arrested-vasodilated 5 +/- 6 mmHg, acetylcholine 23 +/- 6, and from 12 to 128 during barium contracture. These data do not support the suggestion that cessation of epicardial artery flow is solely a capacitance phenomenon.

Congenital Left Main Coronary Artery to Coronary Sinus Fistula

2011 ◽  
Vol 14 (4) ◽  
pp. 255 ◽  
Author(s):  
Fotios A. Mitropoulos ◽  
Meletios A. Kanakis ◽  
Periklis A. Davlouros ◽  
George Triantis
Keyword(s):  
Coronary Artery ◽  
Coronary Arteries ◽  
Coronary Sinus ◽  
Left Main Coronary Artery ◽  
Coronary Artery Fistula ◽  
Left Main ◽  
Coronary Fistula ◽  
Excellent Outcome ◽  
Surgical Ligation ◽  
Congenital Coronary Artery Fistula

Congenital coronary artery fistula is an extremely rare anomaly that may involve any of the coronary arteries and any of the cardiac chambers. We report the case of a 14-year-old female patient with a symptomatic congenital coronary fistula starting from the left main coronary artery and draining to the coronary sinus. The patient underwent surgical ligation of the fistula and had an excellent outcome.

Changes in Hemodynamics and Bradykinin Concentration in Coronary Sinus Blood in Experimental Coronary Artery Occlusion

1977 ◽  
Vol 18 (5) ◽  
pp. 679-689 ◽  
Author(s):  
Keiichi HASHIMOTO ◽  
Masaru HIROSE ◽  
Soichi FURUKAWA ◽  
Hirokazu HAYAKAWA ◽  
Eiichi KIMURA
Keyword(s):  
Coronary Artery ◽  
Coronary Sinus ◽  
Coronary Artery Occlusion ◽  
Artery Occlusion ◽  
Coronary Sinus Blood

Long-Term Follow-Up of Patients With Isolated Side Branch Coronary Artery Disease

Angiology ◽  
2021 ◽  
pp. 000331972110280
Author(s):  
Sukru Arslan ◽  
Ahmet Yildiz ◽  
Okay Abaci ◽  
Urfan Jafarov ◽  
Servet Batit ◽  
...  
Keyword(s):  
Risk Factors ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Vessel Diameter ◽  
Side Branch ◽  
Clinical Risk Factors ◽  
Clinical Risk ◽  
Artery Disease

The data with respect to stable coronary artery disease (SCAD) are mainly confined to main vessel disease. However, there is a lack of information and long-term outcomes regarding isolated side branch disease. This study aimed to evaluate long-term major adverse cardiac and cerebrovascular events (MACCEs) in patients with isolated side branch coronary artery disease (CAD). A total of 437 patients with isolated side branch SCAD were included. After a median follow-up of 38 months, the overall MACCE and all-cause mortality rates were 14.6% and 5.9%, respectively. Among angiographic features, 68.2% of patients had diagonal artery and 82.2% had ostial lesions. In 28.8% of patients, the vessel diameter was ≥2.75 mm. According to the American College of Cardiology lesion classification, 84.2% of patients had either class B or C lesions. Age, ostial lesions, glycated hemoglobin A1c, and neutrophil levels were independent predictors of MACCE. On the other hand, side branch location, vessel diameter, and lesion complexity did not affect outcomes. Clinical risk factors seem to have a greater impact on MACCE rather than lesion morphology. Therefore, the treatment of clinical risk factors is of paramount importance in these patients.

Side branch FFR after provisional stenting: simplified approach based on OCT frame count

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
A Kini ◽  
N Okamoto ◽  
N Barman ◽  
Y Vengrenyuk ◽  
K Yasumura ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Functional Significance ◽  
Area Under The Curve ◽  
Side Branch ◽  
Funding Source ◽  
Fractional Flow ◽  
Simplified Approach ◽  
Main Vessel ◽  
Bifurcation Lesions ◽  
Provisional Stenting

Abstract Background/Introduction Treatment of bifurcation coronary artery lesions remains a major challenge in interventional cardiology. Side branch (SB) stenoses are frequently observed after stent implantation in bifurcation lesions, although angiographically narrowed SBs may not be functionally significant. Fractional flow reserve (FFR), a pressure-derived index of the hemodynamic significance of a coronary artery stenosis, may be useful in determining whether additional intervention is required in jailed SBs. Angiography and intravascular ultrasound (IVUS) derived parameters have showed poor diagnostic accuracy in predicting the functional significance of jailed SBs. Purpose The aim of the present study was to use high resolution optical coherence tomography (OCT) imaging to predict functionally significant SB stenoses after provisional stenting defined as SB FFR ≤0.80. Methods Seventy-one patients with 71 calcified bifurcation lesions with angiographically intermediate SB stenoses undergoing provisional stenting were enrolled in the prospective study. OCT pullbacks were performed before and after stent placement, and SB FFR was measured after main vessel stenting. SB ostium area (SBOA) was assessed using three-dimensional OCT cut-plane analysis off-line. In addition, we developed a simplified approach to SB ostium assessment based on SB ostium frame count using two-dimensional OCT pullback not requiring off-line 3D reconstruction. For the analysis, consecutive frames were counted between the most distal and most proximal take-off of the SB frames. Results Similar to previous studies, quantitative coronary angiography findings were not associated with the functional significance of SBs after main vessel stenting. In contrast, SBOA assessed by 3D-OCT after provisional stenting strongly correlated with post-procedure SB FFR. The optimal cut-off value for the SBOA area to predict a SB FFR ≤0.80 was 0.76 mm2 (sensitivity 82%, specificity 89% and area under the curve of 0.92 (95% CI: 0.84–0.99). A simplified approach to SB ostium assessment using OCT frame count yielded a sensitivity of 82%, specificity 89% and area under the curve 0.92 (95% CI: 0.84 to 0.99) with a cut-off of 4.5 frames allowing detection of functionally significant SB stenoses during the procedure in real time. Figure 1 shows a receiver-operating characteristic curve for SB FFR ≤0.8 and a representative case with SB FFR = 0.66 after provisional stenting and SB ostium frame count equal 3 (Frame 1 to 3) Conclusion(s) Assessment of SB using either 3D OCT off-line reconstruction or a simplified approach based on OCT frame count can detect SB branches with FFR ≤0.80 with high sensitivity and specificity. The developed approaches may represent a useful tool to assess provisional stent outcomes. Figure 1 Funding Acknowledgement Type of funding source: Private grant(s) and/or Sponsorship. Main funding source(s): Boston Scientific; St. Jude Medical

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