This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Pandian, N. G. Articles by Kerber, R. E. Search for Related Content PubMed PubMed Citation Articles by Pandian, N. G. Articles by Kerber, R. E.

Circulation, Vol 66, 603-611, Copyright © 1982 by American Heart Association

ARTICLES

Two-dimensional echocardiography in experimental coronary stenosis. II. Relationship between systolic wall thinning and regional myocardial perfusion in severe coronary stenosis

NG Pandian, RA Kieso and RE Kerber

To determine if there is a quantitative relationship between systolic contraction abnormalities (demonstrated by two-dimensional echocardiography) and reduced myocardial perfusion in a setting of moderate and severe coronary stenosis, we created 70% or 90% reduction in circumflex coronary artery diameter in open-chest dogs. Transient ischemia was induced by superimposing increased myocardial oxygen requirements (i.v. isoproterenol, aortic constriction) in the presence of the stenosis or by decreased coronary perfusion (lowering arterial pressure with i.v. nitroprusside, nitroglycerin, or hemorrhage). Acute systolic wall thinning show by two-dimensional echocardiography or by implanted myocardial sonomicrometers was taken as functional evidence of myocardial ischemia. Myocardial perfusion was determined by radiolabeled microspheres when wall thinning was apparent. Systolic wall thinning could not be induced by these interventions when the degree of coronary stenosis was only 70%. Systolic wall thinning occurred only when increased myocardial oxygen requirements or decreased aortic pressure were superimposed on 90% coronary stenosis. Under these conditions, myocardial perfusion was reduced to 28 +/- 27 ml/100 g/min (mean +/- SD), 15--25% of control. Aortic diastolic pressure was a major determinant of ischemia in that contraction abnormalities produced by a 90% stenosis and vasodilators or hemorrhage could be acutely reversed by superimposing acute aortic constriction, which elevated arterial pressure; myocardial perfusion increased correspondingly. Thus, the demonstration of transient systolic wall thinning by two-dimensional echocardiography during a stressful intervention indicated that severe coronary stenosis was present, and that the perfusion of the acutely dyskinetic myocardial area was 25% of control or less.

This article has been cited by other articles:

				V. Mor-Avi, E. G. Caiani, K. A. Collins, C. E. Korcarz, J. E. Bednarz, and R. M. Lang Combined Assessment of Myocardial Perfusion and Regional Left Ventricular Function by Analysis of Contrast-Enhanced Power Modulation Images Circulation, July 17, 2001; 104(3): 352 - 357. [Abstract] [Full Text] [PDF]

				V. Mor-Avi, K. A. Collins, C. E. Korcarz, M. Shah, K. T. Spencer, and R. M. Lang Detection of regional temporal abnormalities in left ventricular function during acute myocardial ischemia Am J Physiol Heart Circ Physiol, April 1, 2001; 280(4): H1770 - H1781. [Abstract] [Full Text] [PDF]

				V. Mor-Avi, P. Vignon, R. Koch, L. Weinert, M. J. Garcia, K. T. Spencer, and R. M. Lang Segmental Analysis of Color Kinesis Images : New Method for Quantification of the Magnitude and Timing of Endocardial Motion During Left Ventricular Systole and Diastole Circulation, April 15, 1997; 95(8): 2082 - 2097. [Abstract] [Full Text]

				G. Ambrosio, S. Betocchi, L. Pace, M. A. Losi, P. Perrone-Filardi, A. Soricelli, F. Piscione, J. Taube, F. Squame, M. Salvatore, et al. Prolonged Impairment of Regional Contractile Function After Resolution of Exercise-Induced Angina: Evidence of Myocardial Stunning in Patients With Coronary Artery Disease Circulation, November 15, 1996; 94(10): 2455 - 2464. [Abstract] [Full Text]

				R. M. Lang, P. Vignon, L. Weinert, J. Bednarz, C. Korcarz, J. Sandelski RDMS, R. Koch, D. Prater, and V. Mor-Avi Echocardiographic Quantification of Regional Left Ventricular Wall Motion With Color Kinesis Circulation, May 15, 1996; 93(10): 1877 - 1885. [Abstract] [Full Text]