Coronary Heart Disease Improvement in Coronary Blood Flow Velocity With Acute Biventricular Pacing Is Predominantly Due to an Increase in a Diastolic Backward-Travelling Decompression (Suction) Wave
نویسندگان
چکیده
Andreas Kyriacou, MBChB, MRCP; Zachary I. Whinnett, MRCP, PhD; Sayan Sen, MBBS, MRCP; Punam A. Pabari, MBChB, MRCP; Ian Wright, BSc; Richard Cornelussen, PhD; David Lefroy, MB, BChir, MA; D. Wyn Davies, MD, MBChB; Nicholas S. Peters, MD, MBChB, FRCP; Prapa Kanagaratnam, MRCP, PhD; Jamil Mayet, MD, MBA, FESC, FRCP; Alun D. Hughes, MBBS, PhD; Darrel P. Francis, MA, MD, FRCP; Justin E. Davies, MRCP, PhD
منابع مشابه
Improvement in coronary blood flow velocity with acute biventricular pacing is predominantly due to an increase in a diastolic backward-travelling decompression (suction) wave.
BACKGROUND Normal coronary blood flow is principally determined by a backward-traveling decompression (suction) wave in diastole. Dyssynchronous chronic heart failure may attenuate suction, because regional relaxation and contraction overlap in timing. We hypothesized that biventricular pacing, by restoring left ventricular (LV) synchronization and improving LV relaxation, might increase this s...
متن کاملA step toward clinically applicable noninvasive coronary wave intensity analysis.
THE MECHANISMS UNDERLYING a striking diastolic predominance of left ventricular coronary arterial blood flow have been the subject of intensive investigation for many years, starting with the first reliable measurements of phasic coronary arterial flow by Gregg and Green (9) in 1940. Subsequent detailed and elegant experimental studies (3, 20, 23-25) have shown that an increased coronary perfus...
متن کاملEffects of Epicardial and Endocardial Cardiac Resynchronization Therapy on Coronary Flow: Insights From Wave Intensity Analysis.
BACKGROUND The increase in global coronary flow seen with conventional biventricular pacing is mediated by an increase in the dominant backward expansion wave (BEW). Little is known about the determinants of flow in the left-sided epicardial coronary arteries beyond this or the effect of endocardial pacing stimulation on coronary physiology. METHODS AND RESULTS Eleven patients with a chronica...
متن کاملEvidence of a dominant backward-propagating "suction" wave responsible for diastolic coronary filling in humans, attenuated in left ventricular hypertrophy.
BACKGROUND Coronary blood flow peaks in diastole when aortic blood pressure has fallen. Current models fail to completely explain this phenomenon. We present a new approach-using wave intensity analysis-to explain this phenomenon in normal subjects and to evaluate the effects of left ventricular hypertrophy (LVH). METHOD AND RESULTS We measured simultaneous pressure and Doppler velocity with ...
متن کاملPercutaneous Coronary Intervention Enhances Accelerative Wave Intensity in Coronary Arteries
BACKGROUND The systolic forward travelling compression wave (sFCW) and diastolic backward travelling decompression waves (dBEW) predominantly accelerate coronary blood flow. The effect of a coronary stenosis on the intensity of these waves in the distal vessel is unknown. We investigated the relationship between established physiological indices of hyperemic coronary flow and the intensity of t...
متن کامل