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Coronary Back Flow Pressure is Elevated in Association with Increased Left Ventricular End-Diastolic Pressure in Humans

First Department of Medicine, Osaka University School of Medicine, Suita, Japan.

Tohru Masuyama, M.D., F.A.C.A.

First Department of Medicine, Osaka University School of Medicine, Suita, Japan.

Kazuhiro Yamamoto, M.D.

First Department of Medicine, Osaka University School of Medicine, Suita, Japan.

Toshiaki Mano, M.D.

First Department of Medicine, Osaka University School of Medicine, Suita, Japan.

Johji Naito, M.D.

First Department of Medicine, Osaka University School of Medicine, Suita, Japan.

Reiko Nagano, M.D.

First Department of Medicine, Osaka University School of Medicine, Suita, Japan.

Hiroya Kondo, M.D.

First Department of Medicine, Osaka University School of Medicine, Suita, Japan.

Masatsugu Hori, M.D.

First Department of Medicine, Osaka University School of Medicine, Suita, Japan.

To clarify the effect of left ventricular (LV) diastolic pressure on the coronary pressure- flow relation in humans, the instantaneous diastolic coronary pressure-Doppler flow velocity relation was analyzed at rest and during papaverine-induced maximal vasodila tion in 15 patients with angiographically normal coronary arteries. The values for slope (PF) and zero-flow pressure intercept (Pzf index) of the instantaneous diastolic coronary pressure-flow velocity relation were obtained by a linear regression analysis. Although PF did not correlate with LV end-diastolic pressure (EDP), the Pzf index correlated posi tively with LVEDP both at rest and during maximal vasodilation (r=0.64, P < 0.05 and r=0.58, P < 0.05, respectively). Thus, the back pressure to coronary inflow, as indicated by the Pzf index, may be elevated in patients with increased LVEDP, resulting in the rightward shift of the maximally dilated coronary pressure-flow relation and decreased maximal coronary flow and reserve at any given perfusion pressure.

Angiology, Vol. 47, No. 11, 1047-1051 (1996)
DOI: 10.1177/000331979604701104


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