The evolution of left ventricular dysfunction in 36 patients with coronary artery disease and no interim surgical intervention was studied over a mean interval of 26 months (range 6-71 months). The ejection fraction decreased 0.08 (p < 0.001) on the average in patients with coronary artery disease progression. However, progression of coronary artery disease was not accompanied by a decrease in ...

BACKGROUND Thus far, it is unknown whether there is functional collateral flow through preexisting anastomoses in patients with angiographically normal coronary arteries. Such preformed coronary collateral vessels could form the basis for subsequently developing protective natural bypasses in the presence of coronary artery disease. METHODS AND RESULTS Among 100 patients, the collateral flow ...

The role of free radicals in myocardial reperfusion injury remains controversial. We have developed a new method using ascorbyl free radical (AFR) as a real-time, quantitative marker of free radical generation during myocardial reperfusion. A total of 35 dogs were studied. Twelve open-chest dogs underwent either 5 minutes (n = 5) or 20 minutes (n = 7) of coronary artery occlusion and 30 minutes...

Platelet survival time is frequently shortened in patients with coronary artery disease, and it is one of several factors that might contribute to graft occlusion after saphenous vein coronary artery bypass (CAB). In 35 patients with CAB, average platelet survival (autologous labeling with 51Chromium) was shortened in 20 with one or more saphenous vein grafts occluded and normal in 15 with all ...

Sudden complete occlusion of a major coronary artery (left circumflex or right coronary artery) was produced in anesthetized dogs. The effect on arterial inflow, venous outflow and O« saturation of coronary venous blood from the nonischemic left ventricle was studied. The usual response to occlusion of the left circumflex artery was an increase in flow in the left anterior descending artery and...

We measured indices of energy metabolism in tissue samples taken from the interventricular septum and left ventricular free wall of open-chest dogs under control conditions and after a 20-second period of no coronary inflow. The heart was paced at 150 beats/min, and arterial pressure was controlled by aortic constriction. Each tissue sample was divided into three transmural regions and analyzed...

Our purpose was to determine whether prolonged myocardial ischemia attenuates free radical production after early reperfusion. Twenty-two mongrel dogs underwent left anterior descending coronary artery occlusion for 20, 40, or 60 minutes followed by 30 minutes of reperfusion. Electron paramagnetic resonance spectroscopy was used to measure ascorbate free radical in the coronary vein effluent. A...

BACKGROUND Since percutaneous transluminal coronary angioplasty (PTCA) was first introduced in 1977 by Gruentzig as a treatment for proximal short-segmental, non-calcified, concentric isolated coronary stenosis, it has been used with increasing frequency in patients of symptomatic coronary artery disease with broader indications, including patients with multi-vessel disease, unstable angina, ac...

Background. Patients with acute ischemic right ventricular dysfunction often develop hemodynamic compromise, yet most manifest spontaneous early clinical improvement and later recovery of global right ventricular performance. This study was designed to delineate the determinants of right ventricular performance following chronic right coronary artery occlusion. Methods and Results. Thrombotic r...

Coronary spasm can occur in the presence or absence of coronary artery disease. We therefore determined the effect of preexisting coronary stenosis on the incidence of ventricular fibrillation during reperfusion after circumflex artery (CFX) occlusion. Twenty dogs underwent a 30-minute open-chest CFX occlusion. During reperfusion, CFX blood flow was restricted by a partial occluder. In dogs tha...